problem, express what the problem is in one sentence. date owner who owns the problem? who helps with solving it? problem description why is this a problem? how big is the problem? agree on scope. problem as a gap to a standard. risk for business impact of the problem. priority and importance of the problem. root-cause analysis use the five whys, or a fishbone diagram to find the causes for the problem. countermeasure plan decide on two or three possible causes for the problem. grasp the situation identify point of cause: exact place and reason the process goes wrong. execution plan details the way countermeasures will be effectively implemented, preferably with time frames. checking results instead of moving to something else, carefully check that the problem has been eliminated and solved. measure the effectiveness of the countermeasures and their impact on the overall process. followup and learning points effective solutions have a high chance to be applied elsewhere. weave solutions back into the process for the next cycle. also every problem solved often uncovers other issues which can now be details for further consideration. A3