A tradition of excellence TR-823 REV / Restricted Proprietary Information. Marvin Group proprietary rights are included in the information disclosed herein. Recipient by accepting this document agrees that neither this document, nor the information disclosed herein, nor any part thereof shall be reproduced or transferred to other documents or used or disclosed to others for manufacturing or for any other purpose except as specifically authorized by Marvin Engineering. The 5 Whys: An Introduction January 21, 2014

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 2 Motivation When something goes wrong, we tend to see it as a crisis and seek to blame. The majority of the corrective action responses we receive from our suppliers stop their problem analysis at the operator or inspector level. A better way is to see it as an opportunity to learn about our system and processes, and how to make it harder for someone to make a mistake. Today we will learn the technique of asking Why five times to discover why the process failed.

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 3 Introduction to the 5 Why Method The 5 Whys is a method to explore cause and effect relationships. We peel away the symptoms to identify root causes. Overview Engage employees directly involved with the problem Analyze the process to discover weaknesses that: Cause the defect Waste our time Hurt our companys reputation Eat our profits

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 4 Introduction to the 5 Why Method Assume any problem is preventable and worth preventing Problems are caused by weak or poorly defined processes more than individual incompetence Commit to making an investment in the corrective action(s) needed to eliminate the defect INTENT - Make it harder for someone to make a mistake Overview StartFinish

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 5 Five Whys Preparation ProblemRoot Causes Corrective Actions Root Cause analysis Tool Examples: 5 Whys Cause Map Five Whys is one of many Root Cause Analysis Tools Not Recommended: Cause & Effect Diagram (Fishbone)

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 6 Five Why – A Simple Example Problem - Flat Tire Why? There is a tack in the tire Why? Car ran over tacks Why? Tacks on garage floor Why? Box of tacks on shelf split open Why? Box is wet Why? Rain entered hole in roof Why? A roof shingle is missing Why? Wind storm blew shingle off Ask Why? about 5 times and you will likely discover a systemic cause for the problem. Action Condition

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 7 Marvin Engineering uses a 2-legged 5 Why to addresses different systemic issues. How was the problem created? Why was the problem not detected? Failing to detect the nonconformity allowed it to escape to the customer. Five Whys Preparation

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 8 Five Whys Leg One My car will not start The battery is dead The alternator is not working The alternator belt broke The belt was old and beyond its useful service life Car was not maintained according to recommendations Follow manufacturer recommendations Replace the belt Recharge the battery

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 9 Five Whys Leg Two Leg 2 is needed only when there is an escape. An escape is a defect that gets passed on undetected to the next work center and/or to the customer. The quality system did not detect the defect

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 10 Car was not maintained according to recommendations My car will not start The alternator is not working The alternator belt broke The belt was old and beyond its useful service life Why? The battery is dead Check Your Logic

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 11 Check Your Logic Begin with the last Why. Read it, say the word therefore, and continue backward to the first Why. My car will not start The battery is dead The belt was beyond its useful service life The alternator is not working The alternator belt broke My car was not maintained according to recommendations Therefore

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 12 Why? Problem: The Jefferson Memorial is deteriorating Too much washing Excess bird droppings Lots of spiders to eat Lots of bugs to eat Lights are switched on before dusk Why? Deeper Whys Yield Better Solutions Example : Jefferson Memorial

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 13 Deeper Whys Yield Better Solutions Problem Statement: Jefferson Memorial is Deteriorating Excess bird droppings Why? Too much washing was why the Memorial was deteriorating Lots of spiders to eat Why? Lots of bugs to eat Why? Bug Spray – Would eliminate the bugs, but introduces new problems (e.g. health concerns). Lights are switched on before dusk Why? Turn lights on ½ hour later – a less costly solution without side affects. Too much washing Why?

TR-823 REV / - 01/21/2014 © The Marvin Group 2013 PAGE 14 Questions? Introduction to the 5 Why Method