4D PROBLEM SOLVING REPORT

Summary Worksheet
Date Initiated: Concern/Issue #:
Problem Owner Information Product Information Problem Initiator Information / Customer
Company Name: Part Number: Company Name:
Co. Location/Identifier: Co. Location/Identifier:
Team Lead Name: Part Description: Initiator Name:
Team Lead Title: Initiator Title:
Phone/email: Program Name: Phone:
Executive Champion Name/Title: Email:
D1 - PROBLEM DESCRIPTION
Problem Identification Sketch or Photo
Customer effect/Customer Complaint:

Customer Requirement:

Deviation from Customer Requirement:

Where/When is the problem occurring:

Frequency of the problem? Problem Solving Goal Statement & Target Timing:

Describe the measurement method to evaluate problem (include capability):

D2 - ROOT CAUSE ANALYSIS

Root Cause Analysis
Problem
Why was
the Why? Why? Why? Why? Why? Employee Machine Measuremen
problem t
not
detected

Why did the Why? Why? Why? Why? Why?

problem
occur
 4D PROBLEM SOLVING REPORT
Summary Worksheet
Why Date
did theInitiated: Concern/Issue #:
problem
occur
Metho Material Environme
d nt
Why a Why? Why? Why? Why? Why?
systemic
issue

3 x 5 Why Analysis Results

Failure Mode Cause: SRC
Systemic Root Cause – What in the planning Confirmed
Escape Root Cause – ERC Confirmed? process failed to predict this problem ?
Why was NC product
shipped?
Occurrence Root Cause SRC Confirmed? Key Findings – Findings that could drive
– Why was NC product improvement in higher-level processes?
made?
D3 : SELECT AND IMPLEMENT PERMANENT CORRECTIVE ACTION
Choose & Implement Corrective Actions
Escape Corrective Actions: Responsible Due Date Status
1)
2)
3)
Occurrence Corrective Actions:
1)
2)
3)
Systemic Corrective Actions:
1)
2)
3)
Key Findings Actions:
1)
2)
 4D PROBLEM SOLVING REPORT
Summary Worksheet
Date Initiated: Concern/Issue #:
3)
Status Codes Defined: Action Identified Action Validated Action Implemented Closed
Verify Effectiveness of Implement Actions
Corrective Actions Ongoing Performance Enter Number Resolved* Not Resolved**
Escape Verification: Measurements over past days have shown problem to be:
Occurrence Verification: Measurements over past days have shown problem to be:
Systemic Verification: Measurements over past days have shown problem to be:
Resolved* Not Resolved**
D4 : PREVENTION OF RE-OCCURRENCE
Close Problem Do following documents require an update ?
Date
Replicate Corrective Action Responsible Date Responsible Date Planned Closed
PFMEA
Control Plan
Work Instruction
Procedures
Forms / Formats
Maintenance Instructions
Lessons Learned
Others
Others
Others
Capture Lessons Learned
Close Problem
Approve Closure
Name Role Company Date
(Y or N)?