SAINT MARY’S UNIVERSITY

Bayombong, Nueva Vizcaya, Philippines

SCHOOL OF HEALTH AND NATURAL SCIENCES
CENTER FOR NATURAL SCIENCES

HIS REVIEWER
LESSON 6-10
Lesson 6: HEALTH MANAGEMENT INFORMATION SYSTEM
INTRODUCTION
Healthcare administration were managed manually, traditionally starting from then patient registration to
consultation.
 creation of documents proved to be time-consuming
 posted a risk of having duplicate records
 need for proper storage, which if not considered and practiced, could result to difficulty in retrieval
and high cost maintenance.
Getting an overview of the number of patients visiting the hospital, or the nature of problems that needed
immediate action, or even providing pertinent reports was very difficult to achieve. There are neither
snapshots nor a dashboard view, which is an important tool in the analysis of the performance of the
hospitals.
Accurate and real time records for equipment and drugs could not be obtained in a timely manner using
the traditional process, giving rise to the challenges such as
 Accountability
 Monitoring expiry dates
 Stocks
 Auto-indenting

The Problems faced by hospitals using the traditional manual process:

 No real-time data available to monitor the performance of the hospital
 Evidence-based program management was a challenge
 Undue delays in receipt of data
 Retrieval of old manual records was ineffective and time-consuming
 Duplication of records
 SAINT MARY’S UNIVERSITY
Bayombong, Nueva Vizcaya, Philippines
SCHOOL OF HEALTH AND NATURAL SCIENCES
CENTER FOR NATURAL SCIENCES

 Monthly reports send as hard copy, which is a real challenge for data analysis/comparison
 Drug inventory/equipment inventory maintenance
 Lack of standard names and code

Health Management Information System (HMIS) - addresses the need to enhance the management of
the healthcare services and to have a real-time data availability to monitor the hospital performance.
DEFINE CONCEPT, ROLE, AND FUNCTIONS OF HMIS
HMIS DEFINED
Health Management Information System (HMIS)
- an information system specially designed to assist in the management and planning of health programs,
as opposed to delivery of care. (WHO, 2004).
- one of the six building blocks essential for health system strengthening. It is a data collection system
specifically designed to support planning, management, and decision-making in health facilities and
organizations.
H- HEALTH: clinical studies assist in the understanding of medical terminology, clinical procedure, and
database processes.
M- MANAGEMENT: management principle enhanced by finance, law, and planning help administer the
health care enterprise.
IS- INFORMATION SYSTEMS: the ability to analyze systems and to design and implement advanced
computer applications makes the transfer of patient information efficient and effective.
 a set of integrated components and procedures organized with the objective of generating
information, which will improve health care management decisions at all levels of the health
system.
 a routine-monitoring system that monitors and evaluates the process with the intention of
providing warning signals through the use of indicators.
 At the health unit level, HMIS is used by the health unit in charge and the Health Unit Management
Committee to plan and coordinate health care services in their catchment area.
According to the Ministry of Health (2010), HMIS was developed within the framework of the ff. concepts:
The information collected is RFIC
R- relevant to the policies and goals of the healthcare institution, and to the responsibilities of the
professionals at the level of collection.
 SAINT MARY’S UNIVERSITY
Bayombong, Nueva Vizcaya, Philippines
SCHOOL OF HEALTH AND NATURAL SCIENCES
CENTER FOR NATURAL SCIENCES

F- functional; it is to be used immediately for management and should not wait for feedback from higher
levels
I- integrated; there is one set of forms and no duplication of reporting.
C- collected on a routine basis from every health unit.
ROLES OF THE HMIS
major role: provide quality information to support decision-making at all levels of the health care system in
any medical institution.
Ministry of Health (2010) – HMIS aims to aid in the setting of performance targets at all levels of health
service delivery and to assist in assessing performance at all levels of the health sector.
HMIS needs to be:
 Complete – should provide information on all key aspects of the health systems without
duplication.
 Consistent – if similar information is provided by different source, their definitions need to be
consistent.
 Clear – should be very clear what all the elements are actually measuring.
 Simple – should not be unnecessarily complicated.
 Cost-effective – actual usage of each element should justify the costs of its collection and analysis.
 Accessible – data should be held in a form readily accessible to all legitimate users, and it should be
clear who these people are.
 Confidential – should ensure that people without legitimate access are effectively denied.

FUNCTIONS OF HMIS
Ministry of health (2010) – the information from the HMIS can be used in planning, epidemic prediction
and detection, designing interventions, monitoring, and resource allocation.
THREE FUNDAMENTAL INFORMATION-PROCESSING PHASES:
 Data Input – includes data acquisition and data verification.
 Data Management – also called processing phase; includes data storage, data classification, data
update, data computations.
 Data Output – includes data retrieval and data presentation.

EIGHT ELEMENTS OF THE HMIS

Tan (2010) enumerated the ff, elements of a Health Management Information System:
 SAINT MARY’S UNIVERSITY
Bayombong, Nueva Vizcaya, Philippines
SCHOOL OF HEALTH AND NATURAL SCIENCES
CENTER FOR NATURAL SCIENCES

 Data Acquisition – involves both the generation and the collection of accurate, timely, and relevant
data. In HMIS, this is normally achieved through the input of standard coded formats (e.g., the use of
bar codes) to facilitate the rapid mechanical reading and capturing of data.
 Data Verification – involves the authentication and validation of gathered data. The quality of
collected data depends largely on the authority, validity, and reliability of the data sources.
 Data Storage – preservation and archival of data may be regarded as part of the data storage
function.
 Data Classification – known as Data Organization, critical function for increasing the efficiency of
the system when the need arises to conduct a data search.
 Data Computation – involves various forms of data manipulation and data transformation, such as
the use of mathematical models, statistical and probabilistic approaches, linear and nonlinear
transformation, and other data analytic processes.
 Data Update – maintain current data, mechanisms must be put in place for updating changes in the
face of any ongoing manual or automated transactions.
 Data Retrieval – concerned with processes of data transfer and data distribution.
 Data Presentation – has to do with how users interpret the information produced by the system.

LIST OF FUNCTIONS IN HMIS

Listed are the range of possible data and functions that may be
Function Data
Client data Client Billing Data
Client Clinical Data
Scheduling Linking Schedule to Billing
Authorization Tracking Authorized and Use of Authorized Units
Billing Complaint Electronic Claim
Accounts Receivable (A/R) Management Tracking Aging of Unpaid Services
Tracking Reasons for Denials
Aged Receivable Report by Player Source
Reporting Basic Reports
Reposrt Writer
Medical record Assessment
Treatment Plan
 SAINT MARY’S UNIVERSITY
Bayombong, Nueva Vizcaya, Philippines
SCHOOL OF HEALTH AND NATURAL SCIENCES
CENTER FOR NATURAL SCIENCES

Progress/encounter Notes
Compliance Expired Treatment Plan
Service on Treatment Plan
Progress Note Present
Financial General Ledger
Payroll
Accounts Payable
Financial Reporting

DETERMINANTS OF HMIS PERFORMANCE AREA

Behavioral Determinants
 The data collector and users of the HMIS need to have confidence, Motivation, and competence to
perform HMIS tasks in order to improve the Routine Health Information System (RHIS)
 Aqil, Lippeveld, and Hozumi (2009) – the chance of being performed is affected by the individual
perceptions on the outcome of what is being performed and the complexity of the task being
peformed.
 Lack of enough knowledge on the use of data has been found to be a major drawback on data
quality and information use.
 Motivating HMIS users remain a challenge

Organizational Determinants
 Health workers and data collectors work in organizations’ environments which have value, norms,
culture, and practice.

 Design and Implementation of Health Information Systems (2000) – The most important
organizational factor which affects the RHIS process is related to structure, resource, procedure,
support services, and culture which is used to develop and improve the RHIS process.

 Factors affecting the RHIS process:

 lack of funds
 human resource
 SAINT MARY’S UNIVERSITY
Bayombong, Nueva Vizcaya, Philippines
SCHOOL OF HEALTH AND NATURAL SCIENCES
CENTER FOR NATURAL SCIENCES

 management support

 Sanga (2015) – The effectiveness of the organizational culture is to improve RHIS performance,
promotung a culture of information use, which involves the ability and control o promote values
and beliefs among members of an organization by collecting, analysizing, and using information to
accomplish the organization’s goal and mission.

Technical Determinants
Sanga (2015) – technical factors involve the overall design used in the collection of the information. It
comprises he complexity of the reporting forms; the procedure set forward in the collection of data, the
overall design of the computer software used in the collection of information.

PRISM FRAMEWORK – known as Performance of Routine Information System Management (PRISM), this
conceptual framework broadens the analysis of routine health information systems to include the three key
factors:

BEHAVIORAL DETERMINANTS – knowledge, skills, attitudes, values, and motivation of the people who
collect and use data.

TECHNICAL DETERMINANTS – data collection processes, systems, forms, and methods

ORGANIZATIONAL/ENVIRONMENTAL DETERMINANTS – information culture, structure, resource, roles,

and responsibilities of the health system and key contibutors at each level.

PRISM Comceptual Framework

This framework idenifies the strengths and weaknesses in certain areas, as well as correlation among
areas.
Aids in designing and prioritizing interventions to improve RHIS performance
Aqil, Lippeveld, and Hozumi (2009) – The PRISM Framework defines the various components of the
routine health information system their linkages to produce better quality data and continous use of
 SAINT MARY’S UNIVERSITY
Bayombong, Nueva Vizcaya, Philippines
SCHOOL OF HEALTH AND NATURAL SCIENCES
CENTER FOR NATURAL SCIENCES

information,eading to better health system peformance and, consequently, better health outcomes. It is
founded on performance improvement principles.
LESSON 7: HMIS MONITORING AND EVALUATION
Monitoring
- the systematic collection, analysis and use of information from programs for three basic purposes:
1)Learning from the experiences acquired (learning function)
2)Accounting internally and externally for the resources used
3)the results obtained (monitoring function) and taking decisions (steering function)
 Monitoring function partners and members review the implementation of policy based on
objectives and resources mobilized.

Evaluation
- assessing an ongoing or completed program or policy as systematically and as objectively as possible.
- to be able to make statements about their relevance, effectiveness, efficiency, impact and sustainability.
- determined whether any changes need to be made at a program or policy level, and if so, what they are,
what went well, where is there room for improvement.
 It has both a learning function - the lessons learned need to be incorporated into future proposals
or policy.
* Monitoring and evaluation are complementary.

M & E PURPOSE
Primary aim
-to have a strong M&E and review system in place for the national health strategic plan that comprises all
major disease programs and health systems.
Robust Monitoring and Evaluation (M&E) System (RMES)
-assess the effect of integrated service delivery.
- A guide for successful implementation of integrated services and measures the effect on both service
delivery and use of services (FP/Immunization Integration Working Group, n.d.):
1. Appropriate indicators
2. data collection systems
3. data analysis to support decision-making

M & E PLAN
NATIONAL M&E PLAN AND SYSTEM
- address all components of the framework and lay the foundation for regular reviews during the
implementation of the national plan.
 Existing country health-sector review processes - key events to assess progress and
performance
 Country M&E systems -generate the information needed for global monitoring while minimizing
the reporting burden for countries
 Joint Assessment of National Health Strategies (JANS) and health systems funding platform
provide new opportunities to align all partners around these principles (World Health
Organization, 2010).
Progress of any medical institution are monitored and evaluated through various activities such as:
a) monitoring reports
b)HMIS, surveys
c) evaluation studies

According to the National Health Mission (2014), strategies for operationalizing the framework should:

 be primarily country-focused but also offer the basis for global monitoring;
 address M&E needs for multiple users and purposes, including monitoring program inputs,
processes and results, tracking health systems performance and evaluation;
 facilitate the identification of indicators and data sources, provide tools and guidance for data
analysis, and show how the data can be communicated and used for decision-making
 bring together the monitoring and evaluation work in disease-specific programs with cross-cutting
efforts such as tracking human resources, logistics and procurement, and health service delivery.

M&E FRAMEWORK

Monitoring & Evaluation (M&E) - a core component of current efforts to scale up for better health.

Health System Strengthening (HSS) - global partners and countries have developed a general
framework for M&E

The CORE: strengthening of a common country platform for M&E of HSS which should result from
better alignment of country and global M&E systems and can be used both for:

1. monitoring the health systems funding platform

2. for tracking the performance of specific programs
According to WHO 2009, the Framework addresses:

 Indicator Selection
 Related data sources
 analysis and synthesis practices (including quality assessment)
 performance review
 communication and use

Figure 7.1: WHO

Framework for
Monitoring and
Evaluation of Health
Systems
Reform/Strengthening
The WHO’s M&E of Health Systems Strengthening Framework
- presents the indicator domains and considerations for data collection, synthesis and use along the
pathway for achieving health impact at scale.

Monitoring Medical
Services
- indicators should be
tracked to assess
processes and results
associated with the
various indicator
domains.
-these indicators
provides information
on the strengths and
weaknesses of
implementation, and
can help to identify
“red flags” where
further investigation
and adjustments may
be needed.
RELATIONSHIP BETWEEN M&E WITH HMIS INDICATORS
INDICATOR
- a variable whose value changes
- it measures the value of the change in meaningful units that can be compared to past and future units.
- focuses on a single aspect of a program or project:
 Input
 Output
  overarching objective

Five broad categories

of HMIS indicators
which can be used for
monitoring of key
aspects of the health
system performance
USAID (2013):
1. Reproductive
health
2. Immunization
3. Disease
prevention and
control
4. Resources
utilization
5. Data Quality

Indicators for monitoring FP/Immunization integration

This table provides specific indicators, data sources, and purpose of tracking each indicator in
Reproductive Health area, as listed by the FP/Immunization Integration Working Group.
- it includes a variety of quantitative indicators, it is also important to complement collection of these
data with the use of qualitative techniques in order to better understand nuances of the integration
processes and solicit feedback on the approach.
Indicators for monitoring FP/Immunization integration
Health System Indicators and Data Sources
RELATIONSHIP OF HMIS INDICATORS WITH HEALTH PROGRAM
HMIS (Health Management Information System)
- source of routine data
- for monitoring different aspects of various health programs implemented in the country.
-its indicators must meet the key information needs of monitoring the performance of various health
programs and services and provide a snapshot of the available health resources.
The purpose of these illustrations is
- to provide an in-depth understanding of how HMIS can be used for monitoring program performance and
how it encourages similar in-depth analysis for all health programs and services.
Health programs and services such as:
 Maternal Survival Intervention
 Child Mortality and Child Survival Intervention
 STOP TB Program

The Maternal Survival Strategy and HMIS indicators

Campbell and Graham (2006)
- discuss the following about Maternal Survival Strategies and HMIS indicators:
Maternal Survival Strategies
- lays down a framework for achieving the fifth Millennium Development Goal of reducing maternal
mortality.
- none of the maternal survival intervention alone can reduce the maternal mortality rate but evidences
support packaging of health facility oriented interventions is highly effective and has high coverage of the
intended target group.

HMIS is designed to provide albeit some of the core input, process and output indicators.
HMIS indicators related to pregnancy care interventions are:
 1st antenatal care attendances
 4th antenatal care attendances
 Cases of abnormal pregnancies attended at out-patient departments (OPD) of health facilities
 Institutional cases of maternal morbidity and mortality due to Antepartum hemorrhage (APH),
hypertension and edema reported by In-patient departments (IPD) of health facilities
 Cases of abortion attended at health facilities
 Cases of medical (safe) abortions conducted at health facilities
HMIS indicators related to intrapartum care:
  Deliveries by skilled attendance (at health facilities)
 Deliveries by Health Extension Workers (HEW) (at home of Health Posts)
 Institutional cases of maternal morbidity and mortality due to Obstructed labor
HMIS indicators related to post-partum care:
 1st postnatal care attendance
 Institutional cases of maternal morbidity and mortality due to Postpartum hemorrhage (PPH) and
Puerperal sepsis
HMIS indicators related to inter-partum (between pregnancies) period:
 Family planning method acceptors (New and Repeat)
 Family planning methods issued by type of method

These HMIS indicators duly capture data related to:

 Pregnancy
 intra-partum
 postpartum care

The Child Mortality and Child Survival Interventions

Ethiopia
- is a country who have made great strides towards reducing the under-5 mortalities (Ethiopia Maternal
and Child Health Data (2012)).
In 2010 - under-5 mortalities still remain high at 106 per 1000 live births (LB)
By 2015 - reducing it to 61/1000 LB .
EDHS 2011 - estimated under-5 mortalities to be 88 per 1000 LB that is a 47% decline from 166/1000 LB
in 2000.

The major causes of under-5 deaths in Ethiopia, with under-nutrition attributing to over one third of
these deaths:
 Diarrhea
 Pneumonia
 Measles
 Malaria
 HIV/AIDS
 Birth asphyxia
 Preterm delivery
 Neonatal tetanus and neonatal sepsis

Ethiopia is implementing interventions targeting under 5-year-old children through:

 Universal Immunization Coverage
 Nutrition program
  Integrated Management of Childhood Illnesses and the Community Case Management
of Childhood Illnesses
 Through Health Development Army to – improve water, sanitation and hygiene–
Malaria prevention through Integrated Household Spraying and distribution of
Insecticide Treated Nets (ITN) (USAID, 2013).

Related HMIS indicators are:

 Number of treatments for children under five provided by health facility by disease :
Diarrhea, dysentery, pneumonia, measles, malaria, neonatal tetanus
 Number of infants immunized for measles
 Latrine coverage
 Safe water coverage
 Household with ITN

The STOP TB Program (STP)

Vision: to have a TB free world

Goal: reduce the global burden of TB by 2015, in line with the Millennium Development Goals and the Stop
TB Partnership targets of the World Health Organization (2006).

Main objective: achieve universal access to high-quality care:

 universal access to high quality diagnosis

 patient centered treatment

for all people with TB:

 Those co-infected with HIV

 Those with drug-resistant TB).

Core of the Stop TB Strategy TB: case detection and successful completion of the treatment/cure of the
TB remains. Hence one of the targets linked to the MDGs and endorsed by the Stop TB Partnership is by
2050 to reduce prevalence and deaths due to TB by 50% compared with a baseline of 1990.
The following flowchart puts the HMIS indicators (in green shaded boxes) in the context of the STOP
TB Program:
HMIS Indicators to Monitor STOP TB Program
 TB patients on DOTS
 Number of new smear pulmonary TB cases enrolled in the cohort
 TB Case Detection
 Number of New smear positive pulmonary TB cases detected
 Number of new smear negative pulmonary TB cases detected
 Number of new extra pulmonary TB cases detected
 HIV – TB – Co-infection
 Proportion of newly diagnosed TB cases tested to HIV
 HIV+ new TB patients enrolled in DOTS
 TB Treatment outcome
 Treatment completed PTB+
 Cured PTB+, Defaulted PTB+, Deaths PTB+

KEY POINTS TO REMEMBER

  The primary aim is to have a strong M&E and review system in place for the national health
strategic plan that comprises all major disease programs and health systems.
 Monitoring and evaluation (M&E) is a core component of current efforts to scale up for better
health. Global partners and countries have developed a general framework for M&E of health
system strengthening (HSS).
 There are different HMIS indicators which can be use for monitoring of key aspects of the health
system performance. These are from among the five broad categories – Reproductive health,
Immunization, Disease prevention and control, Resources utilization and Data Quality.
 HMIS is a source of routine data that is necessary for monitoring different aspects of various
health programs implemented in the country. The HMIS indicators have been carefully selected
to meet the key information needs of monitoring the performance of various health
programs and services and provide a snapshot of the available health.

LESSON 8: HMIS DATA QUALIITY

Data quality has become a major concern for large companies especially in the areas of customer
relationship management(CRM), data integration and regulation requirements.
DATA QUALITY- is the overall utility of data set(s) as a function of its ability to be processed easily and
analyzed for a database, data warehouse or data analytics system.
ASPECTS OF DATA QUALITY(3A 2R 2C U)
 Accuracy
 Completeness
  Update status
 Relevance
 Consistency
 Accessibility
 Appropriate presentation
 Reliability

ROUSE 2005 –It is a perception of the data’s appropriateness to serve its purpose in a given context.
Having quality data means that the data is useful and consistent. Data cleansing can be done to raise the
quality of available data.

LOT QUALITY ASSESSMENT SAMPLING(LQAS)

-a tool that allows the use of small random samples to distinguish between different groups of data
elements (or Lots) with high and low quality.
-this technique has a wide application in the industry for decades and has primarily been used for quality
assurance of products.
The concept and application of LQAS technique has been adopted in the context of DISTRICT
HEALTH INFORMATION SYSTEM(DHIS) data quality assurance.
The adaption was comprised of designating health facilities, DHIS monthly reports and group of
data elements as ‘Lots to provide representative samples of data quality and assurance of DHIS.

STEPS IN APPLYING LQAS

- Define the service to be assessed(DQA OF DHIS)
-Identify the unit of interest( a supervisory area, facility, hospital, district)
-Define the higher and lower thresholds of performance based on prior information about the expected
performance of the region of interest
-Determine the level of acceptable error
-From a table, determine the sample size and decision rule for acceptable errors to declare an area as
performing “below expectations”
-The number of errors observed(mismatched data elements) reliability if the facility is performing above
or below expectations
ROUTINE DATA QUALITY ASSESSMENT(RDQA) -it is a tool simplified version of the Data Quality
Audit(DQA) which allows programs and projects to verify and assess the quality of their reported data. It
also aims to strengthen their data management and reporting systems.

OBJECTIVES OF RDQA
VERIFY RAPIDLY
- the quality of reported data for key indicators at selected sites
- the ability of data management systems to collect, manage and report quality data.

IMPLEMENT
-corrective measures with action plans for strengthening the data management and reporting
system and improving data quality.

MONITOR
-capacity improvements and performance of the data management and reporting system to
produce quality data.

USES OF THE RDQA TOOL

-Routine data quality checks as part of ongoing supervision
-Initial and follow up assessments of data management and reporting systems
-Strengthening program staff’s capacity in data management and reporting
-Preparation for a formal data quality\
-External assessment by partners of the quality data
*The potential users of RDQA include program managers, supervisors, and M and E staff at
National and subnational levels as well as donors and stakeholders.
IMPLEMENTATION PLAN
-is a project management tool that shows how a project will evolve at high level. It helps to ensure
that a development team is working to deliver and complete tasks on time(Visual Paradigm,2009).
-The development of an implementation plan is important to ensure that the communication
between those who are involved in the project will not encounter any issues and work will also be
delivered on time
KEY COMPONENTS:
 Define Goals/Objectives: Answers the question “What do you want to accomplish?”
Schedule milestones: Outline the high level schedule in the implementation phase
Allocate Resources: Determine whether you have sufficient resources and decide how you will
procurer what is missing
Designate Team Member Responsibilities: Create a general team plan with overall roles that
each team will play
DATA QUALITY TOOL- analyzes information and identifies incomplete and incorrect data.
 Parsing and standardization – refers to the decomposition of fields into component parts and
formatting the values into consistent layouts based on industry standards and patterns and user
defined business rules.
 Generalized “cleansing” – means the modification of data values to meet domain restrictions ,
constraints on integrity or other rules that define data quality as sufficient for the organization
 Matching – is the deployment and merging related entries within or across data sets
 Monitoring – the deployment of controls to ensure confirmatory of data to business sets by the
organization
 Enrichment – enhancing the value of the data by using related attributes from external sources
such as consumer demographic attributes or geographic descriptors

DATA QUALITY MANAGEMENT(DQM)- integrate profiling, parsing, standardization, cleansing and

matching processes(Goasdue Nugier, Dequennoy and Laboisse 2017)
ROOT CAUSE ANALYSIS
-is a class of problem solving methods aimed at identifying the root causes of the problems or events
instead of simply addressing the obvious symptoms
-the aim to improve the quality of the products by using systematic ways in order to be effective
ROOT CAUSE ANALYSIS is among the core building blocks in the continuous improvement efforts of the
organization.
- The analysis will help develop protocols and strategies to address underlying issues and reduce future
errors
THESE ARE THE TECHNIQUES INVOLVED IN ROOT CAUSE ANALYSIS:
 ASK “QHY” 5 TIMES (FIVE WHYS ANALYSIS)
– a technique that does not only work for a clever kid wanting to get his or her way but can also help
identifying the root causes of a problem.
-It is practically done by identifying the problem at hand and progressively unveiling the underlying causes
by asking “why” five times.

 FAILURE MODE AND EFFECTS ANALYSIS

- As system failure may take place in varying modes, and a well known technique used to identify these
modes
1. Determine all failure mode(ways in which observed failure occurs)
2. Determine of the number of times a cause of failure occurs
3. Identify actions implemented to prevent a cause of failure from recurring
4. Check if the actions are effective and efficient
Utilization of this technique:
-a new product or process is manufactured
-changes are made to current conditions or to design
-new regulations are implemented
-there is a problem identified through customer feedback

 PARETO ANALYSIS
-it is based on the pareto principle which states that 20% of the work creates 80% of the results.
-potential causes are listed across the bottom of a bar graph with the important cause on the left
and least important on the right.

 FAULT TREE ANALYSIS

-root causes of an undesirable event are determined using ‘Boolean Logic’. They are listed in a
diagram shaped like an inverted tree, hence the name FAULT TREE ANALYSIS. Commonly used in
risk analysis and safety analysis, this technique starts by identifying the undesirable result and
placing it at the top of the diagram.
-all potential causes are then listed down from it until the root causes is identified.

 CURRENT REALITY TIME(CRT)

-when one desires to get the root causes of all the problems in the system all at once
-the first step is to identify the problem or which in this case problems
-‘If then’ statements are used in charting the problems.
-a single cause that links all problems is then ultimately reached.
 FISHBONE OR ISHIKAWA OR CAUSE EFFECT DIAGRAMS
 PEOPLE
 MEASUREMENTS
 METHODS
 MATERIALS
 ENVIRONMENT
 MACHINES
 The 4M’s for manufacturing, 4S’s for service 8 P’s for service

 KEPNER TREGOE TECHNIQUE

-also known as rational process
-it break downs problem to its root causes by not only identifying the causes but by appraising the
situation as well

 RPR PROBLEM DIAGNOSIS

-can be used for determining and analyzing root causes
RPR STANDS FOR:
- Rapid
- Problem
-Resolution

DIF(Discover, Investigate, Fix)

1. Discover- where designated workers gather data and analyze
2. Investigate- team members come up with a diagnostic plan and carefully analyze the diagnostic
data to identify the root cause
3. Fix- the problem is fixed and continuously being monitored to double check if the correct root
cause was determined

SUSTAINING CULTURE OF INFORMATION USE

Choo Bergeron and Heaton (2008)
– states that information culture affects the information use outcomes.
The information cultutre is determined by the following variables:
 Mission
 History
 Leadership
 Employee traits
 Industry
 National culture