Fishbone diagram, also referred to as Ishikawa or Cause-and-effect diagram is used during the process of finding the main cause of a complex problem by arranging ideas into simple, organized and classified groups. As the name suggests, it gives a preview of the causes and the effects. In the head, notably the head of the fish in the fishbone diagram, effects are written, while the side bones of the fishbone diagram are possible causes.

This systematic, virtual diagram provides those in the medical field, customarily pharmacist, with a distinct approach while identifying incidents. They can brainstorm the possible causes related to the effect that has occurred or pre- occurred. First, they identify theories of causes or problems likely to occur, and in each problem is classified with its own causes; the group of problems categorized can be personnel, technological or procedural. Additional categories can be patients, wards or supplies. With this groups in place, it should be evaluated and a trend is known, in order to discover the root cause of all the problems.

For a pharmacist to know the frequent basic root of the problem is much less of a daunting task with fishbone diagram, you just need to grade the repeated causes. In this virtual tool, minor causes are mostly related to three or four major causes. Very often, because of the nature of the field of pharmacy, complex fishbone diagram can be drawn and analysis can be deterred by too much data, it can almost be hard to rank major causes if it requires being done. To prioritize the ranking of major causes is made easy by using Pareto chart. In Pareto chart, the y-axis has the number of frequencies of occurrence, while cumulative percentage occurrence is found on the x-axis. Here are the critical steps needed to be taken when using a fishbone diagram

People in the medical field using fishbone diagram should proceed by first agreeing on the problem. It is essential to be as clear and accurate about the problem as possible. Then write it at the head of the fishbone diagram. This is the effect.

All the participants should assent to bringing the same classifications of major causes of the problem. Using words like environmental factors, rules or policies can be very pragmatic since they reflect a wide scope of problems in any institution.

Participants should then conceptualize of all the existence of the problems and ask ‘why’ on the effect. As problems are raised, mentioned factors are considered and the facilitator must note down classifying it on the right branch on the fishbone diagram. These are the causes.

A further branching is needed by asking the question ‘why’ on the causes that have been just categorized. The end result will be causes branched again into sub-causes.

Participants are additionally required to ask themselves ‘why’ on the sub-causes to find out a more comprehensive and detailed factor contributing to the causes. They need to tirelessly continue with this process until they find the root cause.

A simple fishbone diagram is used to uncover and solve more complex incident by following the above steps. Exclusively from that, it keeps the team concentrating on the effects rather than just the causes.