Root cause analysis (RCA)
Patient Safety
Definition. Root cause analysis is a structured retrospective method for identifying the underlying system factors that contributed to an incident, so that recurrence can be prevented.
Explanation
In health care, RCA examines task, team, environment and organisational factors rather than stopping at the person closest to the event. The London Protocol, now in a new edition, offers a widely used framework for systems analysis of clinical incidents (Vincent et al., 2025).
RCA has been criticised for weak action plans and for focusing on single causes. Better practice involves patients, looks for multiple contributory factors and prioritises strong system-level actions over retraining alone.
Related concepts
Failure mode and effects analysis (FMEA) Incident reporting system Swiss cheese model Human factors Just culture
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References
Vincent, C., Irving, D., Bellandi, T., Higham, H., Michel, P., Staines, A., … & Zambon, L. (2025). Systems analysis of clinical incidents: development of a new edition of the London Protocol. BMJ Quality & Safety, 34(6), 413–420. https://doi.org/10.1136/bmjqs-2024-017987
Cite this entry: Kurutkan, M. N. (2026). Root cause analysis (RCA). In The Health Topics glossary. https://healthtopic.org/glossary/root-cause-analysis/