Incident Investigation: Surface Causes Vs Root Causes
In the world of investigating incidents, it’s important to understand the difference between surface causes and root causes. Knowing to differentiate between the two is what gives an effective solution.
It helps safety experts, investigators, and management teams to figure out not just what happened but why the incident took place. It also leads to stronger solutions that can stop the problem from reoccurring.
Surface Causes Vs Root Causes— Definition
Incidents normally take place because of uncertain circumstances or behaviors, known as surface causes. These are the immediate and direct factors that instantly lead to the reason behind an accident or problem. They are the visible aspects of an incident that can be identified right away.
However, root causes are the underlying and fundamental reasons or weaknesses in a system that give birth to a problem or incident. They are the deeper, hidden issues that, when addressed, can prevent the recurrence of such accidents.
Identifying the root causes involves looking beyond the immediate factors to understand the core issues leading to a problem.
Surface Causes Vs Root Causes — Example
Imagine a situation where a worker slips on an oil puddle in a factory, getting injured. The immediate issue, or surface cause, is the oil spill. Cleaning it up and making the area dry can fix this. However, the deeper issue, or root cause, could be problems in maintenance procedures allowing leaks, insufficient training on clean-up, or not enough resources for regular checks.
Just fixing the oil spill might make it seem like the problem is solved. But if the underlying issues aren’t addressed, similar incidents may happen again, possibly causing more significant problems.
Surface Causes Vs Root Causes — Differences
Surface Cause and Root Cause are terms commonly used in analyzing incidents and managing risks. Here’s how you can differentiate between the two when investigating an incident.
| Features | Surface Cause | Root Cause |
| Cause | Immediate factors directly lead to an incident. | Underlying factors or systematic issues contribute to surface causes. |
| Analysis | The basic investigation is focused on the specific incident. | A deeper look into exploring the problems, policies, procedures, and organizational culture. |
| Example | Surface Cause: An employee slips on a wet floor, and the wet floor is the immediate reason. | Root Cause: The absence of a procedure to quickly clean up spills (an issue with how things are set up) or the procedure not being followed because of a lack of training (a problem with how things are done). |
| Example of Resolution | Cleaning the wet floor to stop another slip. | Putting in place and making sure everyone follows a procedure to quickly clean spills and teaching staff how to maintain things properly. |
| Identification | Usually easy to spot and fix, but only deals with the current issue. | Harder to find and might need big changes in the organization, but tackles the main problem. |
| Outlook | Short-term and quick, paying attention to what happened right before an incident. | Long-term, considering patterns, trends, and bigger issues that built up over time. |
| Result | Stops the same incident from happening again but doesn’t handle other possible dangers. | Stops various incidents by fixing bigger issues in the system. |
Surface Causes Vs Root Causes— Analysis
In most accidents, there’s usually more than one thing that causes the problem. So, investigators need to check for the following:
- Look if the right steps are followed to do the job. Was the normal way of doing things unsafe? Did people use the right gear and tools?
- Think about the machines, chemicals, and equipment. Did something break? Were there warnings for workers?
- Consider the surroundings. Was there enough light or was it too noisy? Was the weather unusual?
- Think about the workers. It’s important not to blame them, but to ask questions. Were they trained right? Were they stressed or sick?
- Check if the supervisors gave clear instructions. Did they check machines often?
Once you recognize the problematic area, keep asking why until you find the main reason. It’s called “The Five Whys.”
For example—
- Why didn’t the employee wear eyewear? Because it didn’t fit well and he thought it made his job harder.
- Why didn’t it fit? Because the company only gives one type of eyewear and doesn’t check if it fits every worker.
- Why only one type of eyewear? Was it too expensive for the company to afford?
Importance of Incident Investigation
Looking into incidents is more than just figuring out who or what caused the problem. It’s about finding out why it happened and fixing that to make work safer.
By doing good investigations, companies can—
- Stop it from happening again
- Keep employees safe
- Make the workplace safer
- Follow the law and rules
Incident Investigation: Surface Causes Vs Root Causes— Conclusion
For a lasting and effective change in preventing accidents, it’s important to understand both the surface and root causes of the incident. While dealing with immediate problems is important for getting things back on track, the real challenge is fixing the root cause. This requires a strategic and cross-functional approach that goes beyond just the incident itself.
At WorkPartners, we provide personalized assessments to identify and address incidents for future safety. We focus on finding the real reasons behind problems to create lasting improvements.
