Solving Problems the '5 Whys' Way

In this nine-minute commentary, Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, discusses a problem-solving solution that he uses in his practice called “the 5 whys” as an alternative to stopgap solutions. He suggests identifying the root cause of the problem, which can easily prevent future occurrences, especially if the solution is inexpensive to implement. Dr. Baum then looks at the implementation of the 5 whys in a urologic setting, using the common issue of scheduling as an example, emphasizing that the purpose of drilling down on causes to a problem is to find the root cause and therefore a solution, rather than placing blame. Dr. Baum then discusses how to implement this approach to solving problem in a urologic practice, emphasizing the need to include all staff in the solution and to focus on long-term success rather than short-term, quick-fix solutions. Finally, he goes over the steps involved in effective problem solving, in particular the need to evaluate the improvements to see if the solution was effective or not.