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Root cause analysis tools and templates

Eighty per cent of diabetes related amputations are avoidable. Root cause analysis (RCA) can help reduce future amputations by determining to what extent an amputation was avoidable or unavoidable, and whether or not it was the best possible outcome for the person with diabetes. If avoidable, completing an RCA will help identify what changes are required to reduce the likelihood of the same event happening again.

Use the following tools and templates to support a root cause analysis into diabetes related amputations.

Data collection tools

  • Data collection template (Excel, 26KB)

    This template features as Appendix 1 in the guide 'How to: use root cause analysis to reduce diabetes related amputations'.This template features as Appendix 1 in the guide 'How to: use root cause analysis to reduce diabetes related amputations'.
  • Primary care data collection template (Excel, 22KB)

    This template features as Appendix 2 in the guide 'How to: use root cause analysis to reduce diabetes related amputations'.This template features as Appendix 2 in the guide 'How to: use root cause analysis to reduce diabetes related amputations'.
  • Guidance for investigations across each service (Word, 18KB)

    The document outlines the areas to investigate across each service as part of a root cause analysis into diabetes related amputations.The document outlines the areas to investigate across each service as part of a root cause analysis into diabetes related amputations.

Tools to complete RCA

Reporting templates

  • Report and action plan template (Word, 14KB)

    This template features as Appendix 4 in the guide 'How to: use root cause analysis to reduce diabetes related amputations'.This template features as Appendix 4 in the guide 'How to: use root cause analysis to reduce diabetes related amputations'.
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