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Joint commission root cause analysis form

Joint commission root cause analysis form

Comply with healthcare standards using our joint commission root cause analysis form. This template assists healthcare organizations in conducting thorough investigations and meeting accreditation requirements.

Use this template
or download pdf
Joint commission root cause analysis form

Comply with healthcare standards using our joint commission root cause analysis form. This template assists healthcare organizations in conducting thorough investigations and meeting accreditation requirements.

Use this template
or download pdf

About the Joint commission root cause analysis form

Using a joint commission root cause analysis form is essential for enhancing patient safety and meeting healthcare standards. This template provides a structured approach to identifying and analyzing the root causes of adverse events. By systematically exploring all contributing factors, you can develop effective strategies to prevent recurrence and improve care quality.

The primary purpose of this form is to help you uncover the underlying reasons for incidents, enabling you to implement corrective actions that enhance patient safety. It organizes information clearly, allowing you to focus on critical areas that need improvement, ensuring a comprehensive analysis.

Additionally, using this form fosters collaboration among healthcare teams, encouraging open discussions and diverse perspectives. It streamlines the process of identifying and addressing safety concerns, leading to more accurate and efficient problem-solving. 

Key elements of a joint commission root cause analysis form

A joint commission root cause analysis form is designed to enhance your documentation and problem-solving processes by providing a structured approach. Here are the key elements that make this template effective:

  • Event description: This section captures the specifics of the incident, including what happened, when, and where. Providing a clear event description ensures everyone understands the context and scope, setting a solid foundation for analysis.
  • Contributing factors: Identify potential factors that may have contributed to the incident, such as procedural lapses, communication issues, or equipment failures. By categorizing these factors, you can systematically explore different areas that might have influenced the incident.
  • Root cause identification: Delve deeper into each contributing factor to determine the root causes. This thorough examination helps ensure that no potential cause is overlooked, allowing for a more accurate and comprehensive analysis.
  • Corrective actions and follow-up: Outline steps to address the identified root causes, assign responsibilities, and set timelines for implementation. This section ensures accountability and facilitates effective resolution, ultimately enhancing patient safety and compliance with joint commission standards.

Customizing your joint commission root cause analysis form

To make the most of a joint commission root cause analysis form, customize it to fit your organization’s specific needs. Start by modifying the contributing factors section to reflect the unique aspects of your healthcare environment. This ensures the analysis is relevant and comprehensive.

You can also adjust the level of detail in each section. For complex incidents, expand the template to include more detailed subcategories and questions. This helps capture all necessary information and facilitates a deeper analysis.

Incorporate your organization’s specific terminology and procedures into the template. This adaptation makes the template more intuitive and easier for your team to use, promoting consistency and efficiency.

Finally, ensure the corrective actions section is flexible enough to accommodate different types of solutions and follow-up procedures. By tailoring the template to your specific context, you enhance its relevance and effectiveness, making it a powerful tool for improving patient safety and compliance with joint commission standards.

Related categories

  • Operational excellence templates
  • General templates
  • Templates for business processes
Preview of the template
Join Commission Standards
Incident Details
Date of Incident
Time of Incident
Location of Incident
Individuals Involved
Description of Incident
Root Cause Identification
What happened?
Why did it happen?
What were the contributing factors?
Corrective Actions
Actions to be taken
Responsible Parties
Completion Timeline

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Topic guides

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Frequently asked questions

What is a joint commission root cause analysis form?

A joint commission root cause analysis form is a structured tool used to identify and analyze the root causes of adverse events in healthcare settings. It helps teams systematically explore contributing factors, ensuring comprehensive solutions that enhance patient safety and compliance with standards.

How does a joint commission root cause analysis improve healthcare outcomes?

This analysis improves healthcare outcomes by providing a clear framework for identifying and addressing the root causes of incidents. It encourages thorough investigation and collaboration, leading to effective corrective actions and reducing the likelihood of future events.

Who should use a joint commission root cause analysis template?

Healthcare professionals, including safety officers, risk managers, and quality assurance teams, should use this form. It benefits anyone responsible for improving patient safety and reducing medical errors by offering a systematic approach to problem-solving.

What are common challenges in conducting a root cause analysis and how can they be overcome?

Common challenges include incomplete data collection and biased analysis. You can avoid the challenges by ensuring thorough data gathering and encouraging diverse team input. Using the form to guide discussions and verify findings with evidence promotes a balanced and accurate approach to problem-solving.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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