Root cause analysis template: base template and example

When to do a root cause analysis

• Safe Work Australia says you should review your control measures after an incident, and when a control isn't working as it should. A root cause analysis is one practical way to do that review.
• Some incidents must be reported to your regulator straight away. Safe Work Australia's incident notification guidance explains what's notifiable, and that the site must be left undisturbed until an inspector says otherwise.
• No law says you have to use a particular method or form. How you notify differs by state and territory, so see what applies in each state below.

Need to record the incident itself first? Get the free incident report template.

Incident notification in your state

If the incident is notifiable, tell your regulator before you start the analysis. How you notify differs between states. We're not a regulator, so check yours:

• New South Wales: call SafeWork NSW immediately on 13 10 50, 24 hours a day. Separately, notify your workers compensation insurer within 48 hours of a workplace injury. See SafeWork NSW's incident notification page

• Victoria: call WorkSafe immediately on 13 23 60, then send written notice within 48 hours and keep a copy for at least 5 years. Notification rules for some plant and equipment incidents changed from 1 July 2024. See WorkSafe Victoria's report an incident page

• Queensland: WorkSafe Queensland

• South Australia: SafeWork SA

• Western Australia: WorkSafe WA

• Tasmania: WorkSafe Tasmania

• Northern Territory: NT WorkSafe

• Australian Capital Territory: WorkSafe ACT

After a notifiable incident, leave the scene undisturbed until the regulator says otherwise, except to help the injured or make the area safe.

Tips for a useful root cause analysis

• Safe Work Australia's risk code sets out the hierarchy of control. When you choose corrective actions, aim to remove or engineer out the hazard before relying on procedures, training or PPE.
• Bring in the people who do the work. Safe Work Australia says workers must be consulted when you're reviewing risks and deciding on controls.
• Keep asking why until you reach something you can fix in your systems, such as maintenance, training, design or supervision, rather than stopping at "the worker made a mistake".

Root cause traps and how to avoid them

Every incident is different, but these are traps that often stop a root cause analysis from finding the real cause, with a way around each:

• Stopping at "the worker didn't follow the procedure": ask why it wasn't followed. Was it unclear, impractical, or never trained?

• Looking for one cause when there were several: list every contributing factor, then pick the ones that would have stopped it.

• Starting the analysis days later: collect photos, statements and records while they're fresh.

• Only talking to supervisors: include the person who does the task, and anyone who saw it happen.

• Corrective actions that are just more training or a reminder: aim higher on the hierarchy of control, such as removing or engineering out the hazard.

• Not checking for the same problem elsewhere: look at similar machines, shifts or sites that could have the same gap.

• Treating near misses as not worth the effort: a near miss with serious potential deserves the same analysis as an injury.

• Blaming people: people are more open about what happened when the aim is fixing systems, not finding fault.

What to include in a root cause analysis

• The site, date, incident reference and who was on the investigation team
• The method you used, such as 5 Whys or a fishbone diagram
• A clear problem statement: what happened, where, and to whom
• A timeline of the events leading up to the incident
• The contributing factors, and the root cause or causes
• Corrective actions with an owner, due date and status, plus sign-off

Common gaps in a root cause analysis

Before you sign it off, check the analysis doesn't have these gaps. Your site's investigation procedure may ask for more:

• The problem statement is vague, such as "injury on line 2", with no what, where or when.

• The 5 Whys stop after one or two answers.

• The root cause is a person, not a system or condition you can change.

• Actions have no owner or due date, or say "ongoing".

• Nobody checks later whether the actions worked, so the record is never closed.

Filled-in root cause analysis example

Example only, not for use as your own analysis. This is the base template filled in for a fictional incident: an operator cut on a carton sealer after a guard interlock was bypassed. Click the page to enlarge it.

Your own analysis must be based on the facts of your incident and site. Track each action until it's done, and check that it worked.

How to fill one in

1. Make the area safe, give first aid, and report the incident to your regulator if it's notifiable.
2. Fill in the details and pick your team, including someone who does the work involved.
3. Write the problem statement, and build a timeline from what people saw, records and photos.
4. Work through the whys and tick the contributing factors until you reach the root cause.
5. Agree corrective actions with owners and due dates, sign it off, and follow up until they're closed.

Get your root cause analysis into the app

This form is in the Shadow Forms app. Your team can fill it in on site, add photos and sign it, then send it straight to the office.

The PDF and Word versions are copies only. If you have your own branded version, or want this one adjusted to your business, we can add it to the app. Upload a form, or get in touch.

Recording a quality issue instead? Get the free non-conformance report template.

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