Do It Form

"*" indicates required fields

Process Owner*

Department*

DO IT Name*

Plan

What is the problem?*

5 Whys

1. Why is this happening?

2. Why?

3. Why?

4. Why?

5. Why?

Ideal State

What are you trying to accomplish?*

What is your success metric?*

Have you brainstormed a solution?*

Yes

If there are multiple solutions, have you voted or reached consensus?*

Yes

DO

Test the solution.

Start Date*

End Date*

Completion*

Completed

In Progress

Did you achieve your success metric?*

Yes

What problems, if any, occurred? (Optional)

Study

Summarize your findings: (Optional)

Act

If you didn't meet your success metric, make the necessary changes and retest. Note the changes you made. Continue to make changes until you meet your success metric. (Optional)

Hardwire the final solution. You should have all team members initial a document that indicates that they understand the new process.

This field is for validation purposes and should be left unchanged.

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Do It Form

Plan

5 Whys

Ideal State

DO

Study

Act

Marshfield Medical Center - Dickinson