The page below is a sample from the LabCE course Risk Management in the Clinical Laboratory. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

Learn more about Risk Management in the Clinical Laboratory (online CE course) »
How to Subscribe
MLS & MLT Comprehensive CE Package
Includes 94 CE courses, most popular
$95 Add to cart
Pick Your Courses
Up to 8 CE hours
$50 Add to cart
Individual course$20 Add to cart

The Fishbone Diagram

One of the tools that can be used when performing a root cause analysis is the cause-and-effect diagram, popularly referred to as the "fishbone diagram" because of its appearance.

Cause-and-Effect (Fishbone) Diagram Example

This type of diagram graphically helps identify and organize known or possible causes for a specific problem or area of concern.

In this theoretical example, the identified problem is a "near miss." Two units of RBCs were taken to the Dialysis Unit for transfusion of two different patients. The first unit was hung by one clinical person and started just as another clinical person noticed that the unit that he/she picked up for transfusing another patient had the wrong identifying information. The blood was stopped immediately on the first patient.

Some of the benefits of constructing a "fishbone diagram" are that it

  • Helps determine root causes using a structured approach.
  • Encourages group participation and utilizes group knowledge.
  • Indicates possible variations in a process.
  • Indicates areas where more data should possibly be collected.