Skip to main content

Table 2 Distribution of Root Causes by Factors

From: Our first review: an evaluation of effectiveness of root cause analysis recommendations in Hong Kong public hospitals

Factors by NPSA Contributory Factors Classification Framework No. % Groups by the RCA Reports Review Team No. %
Patient 22 4% Patient Factors 22 4%
Staff 81 16% Staff Behavioural Factors 233 46%
Task - policy & guideline adherence (the ‘violation’ root causes) 152 30%
Task – others 25 5% System Factors 249 49%
Communication 58 12%
Equipment 33 7%
Work environment 17 3%
Organisation 15 3%
Education & training 87 17%
Team 14 3%
Total 504 100% Total 504 100%