Author: Phone No.

Date:
PRACTICAL PROBLEM SOLVING REPORT
Champion: Phone No. Date:
Report # Repeat Issue?
Problem found by: (circle one): Problem in shift: 1st 2nd 3rd
Environmental
Customer Internal Production Audit / Inspection Other: Sketch:
Issue
Problem Category (circle one):
Safety/Environment Quality Cost Responsiveness Other:

Problem Description / Failure: (Initial)

Point Of Cause (Where problem is first occurring)

Problem Definition: (further details)

Multifunctional Team Members: (Name & Phone)

Process/Part Check * ANY "NO" RESPONSE REQUIRES CORRECTIVE ACTIONS Diagnostic and/or Support Tools Used (Y if used, N if not applicable or not used)
(similar to "7 Diamond Process" Steps 1-5): Y N* Quality Alert Issued for Containment:
Is the SOS / BOS being followed? Fishbone (Direct Cause Analysis)
If No, what System was not followed? 5 Why (Root Cause Analysis) Used
Is correct tool being used? Drill Deep Worksheet Used
Eng. Change Req'd? (*) (if yes, include Ref # for
Is correct part being used?
CAR closure)
Has the operator been trained? (*) EC Referce Number
Do the parts support quality? NO DIAGNOSTIC TOOLS USED
INITIAL RESPONSE PLANNING - DUE WITHIN 24 HOURS (Shade status complete with updates)
Breakpoint
Material Containment & Identification Method Qty Discrepant Qty Reviewed DATE WHO STATUS (**)
(if applicable)
@ Customer:

In-Transit:

In-Plant:

@ Supplier:

Breakpoint
Process Failure Containments DATE WHO STATUS (**)
(if applicable)

FINAL RESPONSE PLANNING - DUE WITHIN 15CALENDAR DAYS (Shade status complete with updates)

Root Cause: WHAT PROCESS CAUSED THE FAILURE?

Where applicable utilize Fishbone (Direct Cause Analysis) & 5 Why (Root Cause Analysis) tools (see page 2 & 3)

Following the Root Cause analysis, what System failured? (APQP, Process Control, Management Review, Training, etc.)

How did the nonconformance escape the facility? Cause Defined (Deep & Wide "Protect"):

Permanent Corrective Action / Long-Term Countermeasures WHO DATE Team Member Initials STATUS (**)

(**) Key for Status: 1. Identified (one fill) 2. Implemented (two fills) 3. Feedback (three fills) 4. Closed (all filled)

Quality Planning Documents Updated (indicate date) DFMEA: PFMEA: Control Plan:

Any Similar Areas where this might apply: (Institutionalization)

Verification Method and evidence evaluated:

CAR Verification by: (Name & Title) Date: Corrective Action Checklist Complete?

Closure Approval: (Name & Title) Date: YES NO

NOTE: INITIAL RESPONSE DUE WITHIN 24 HOURS OF INITIATION. FINAL RESPONSE DUE WITH ROOT CAUSE EXPLANATION DUE WITHIN 15 CALENDAR DAYS.
 REPORT #

Direct Cause Analysis: (Fishbone) FINAL ROOT CAUSE DUE WITHIN 10 CALENDAR DAYS
1) Indicate possible direct causes on
2) Circle most likely direct 2) Circle most likely direct causes.

Man Machine Environment

1 1 1
PROBLEM
2 2 2
3 3 3
4 4 4
5 5 5

Method Material Measurement

1 1 1
2 2 2
3 3 3
4 4 4
5 5 5

( ) ( ? ) ( CROSS OUT )
st Each
Direct Cause of the Problem Possible Direct Cause Not a cause of the problem
TEST POSSIBLE DIRECT CAUSES FROM FISHBONE
Target Actual
Intermediate Action Plans (not containment) Who
Complete Complete
Status

Key for Status: Not started Identified Implemented Feedback Closed

 REPORT #

CORRECTIVE ACTION REQUEST (CAR)

Step 1 Evaluate associated Process(es), Procedure(s), Work Instruction(s), and/or Form(s)
Step 2 Determine root cause by conducting 5-why method (other methods may be used-e.g., Fishbone)
Step 3 Determine Permanent Actions / Long Term Countermeasure corrective action(s) (action to eliminate the cause of nonconformity in order to prevent recurrence)
Step 4 Correcting the finding (how are you going to correct the immediate finding)
Step 5 Determine the corrective action impact (apply to other similar processes and products the corrective action)

PROCESS / PROCEDURE / WORK INSTRUCTION REVIEW:

Which Process(es)/Procedure(s) does this nonconformity rela
Were these documents adequate / suitable?
Root Cause (5 Why) Required
WORK INSTRUCTION / FORMS:
Which Work Instructions(s) / Form(s) does this nonconformity
Were these documents adequate?
Root Cause (5 Why) Required
Root Cause Analysis (5 Why): In the first WHY write down the Direct Causes .
(If you found more than one Possible or Direct Cause, please utilize additional sheets for each Direct Cause)
Why?

Why?

Why?

Why?

System and Process Failure Root Cause:

CORRECTIVE ACTION FOR ROOT CAUSE LISTED ABOVE

Target Actual
Intermediate Action Plans (not containment) Who
Complete Complete
Status
Key for Status: Not started Identified Implemented Feedback Closed
 Drill Deep Worksheet
REPORT #

Issue title:

5 Whys Corrective Action Owner Due Date

Why did the planning P1

process not predict the
defect? P2

P3

Predict P4
Planning process -
inform at ional cont ent P5
in FMEAs and CPs

P-RC

Why did the manufacturing M1

process not prevent the
defect? M2

M3

Prevent M4
Manufact uring process -
st andardized work and
M5
error proofing

M-RC

Why did the quality process Q1

not protect the customer
from the defect? Q2

Q3

Protect Q4
Quality process -
detection & Q5
responsiveness

Q-RC

What are the key findings K1

based on this quality issue
and the above 5 Why
analysis? K2

K3

K4

K5

GM 1927-84 (5.0) (Rev.03/09/0) 6 of 7 775125601.xlsPage 4 - Drill Deep Worksheet

 REPORT #

CUSTOMER ADDITIONAL ( OPTIONAL )

Transfer to Champion: (if necessary) Problem Acceptance Signature:

Date: Name: Area:

Intermediate Action Plans (not containment) Who Due Date Status

Key for Status: Not started Identified Implemented Feedback Closed

LESSONS LEARNED: Could the communication of this problem and its fixes possibly prevent other
departments from incurring the same problem? If Yes, Which Area?

"Send Copy of PPS to"

Body Paint GA

Problem Escalation: What level is the problem currently being supported?

Author
Verification & Resolution Questions:
Has this reoccurred ? Y N N/A Group
Has the JES/SOS been updated ? Y N N/A Leader Shift
Plant
Leader CPIT
Has a CVIS been updated ? Y N N/A Area Manager
Have other forms been updated ? Y N N/A Manager
Date the appropriate box when elevating a problem

Date/ Signature: Author (required for closure) Group Leader/Shift Leader (info only) Area Manager (info only)

A - Shift
B - Shift