Y-statement, post-incident

Usefulness

This template is useful for describing why an incident happened.

Template

The following undesired outcome or occurrence was observed: <YOUR_OBSERVATION_HERE>

The undesired observation was caused by my own prior action or state as follows: <YOUR_PROXIMATE_CAUSE_HERE>

My prior action / state that led to the undesired outcome was caused by the following root causes about one or more of my:

  • values

  • desires

  • needs

  • beliefs

  • ability

  • knowledge

  • skill

  • tooling

  • procedures

<YOUR_ROOT_CAUSES_HERE>

Action items

Remedial response

  • <YOUR_ACTION_ITEM_HERE>

  • <YOUR_ACTION_ITEM_HERE>

Specific procedural response

  • <YOUR_ACTION_ITEM_HERE>

  • <YOUR_ACTION_ITEM_HERE>

Root cause response

  • <YOUR_ACTION_ITEM_HERE>

  • <YOUR_ACTION_ITEM_HERE>