Problem Solving Report Template

Report Title:

Report #:

Author:

Department / Area:

Date Opened:

Date Closed:

Severity: ☐ Critical ☐ Major ☐ Minor

Status: ☐ Open ☐ In Progress ☐ Closed

Section 1 — Problem Description

Problem statement (what is wrong, where, when, how many):

First detected by:

Date first detected:

Frequency:

Products / customers affected:

Business impact (cost / time / quality / safety):

Section 2 — Containment Actions

Immediate actions taken to protect customers and stop the problem from spreading while the root cause is found.

Containment implemented by:

Date / time:

Verification that containment is effective:

Section 3 — Root Cause Investigation

Investigation method(s) used: ☐ 5 Whys ☐ Fishbone ☐ 5W2H ☐ FTA ☐ Other: Root cause of occurrence (why it happened): Root cause of detection failure (why it wasn't caught sooner): Evidence supporting this root cause:

Section 4 — Corrective Actions

#	Action Description	Type (Corrective / Preventive)	Owner	Due Date	Status
1
2
3
4

Section 5 — Results and Verification

Baseline metric (before fix):

Result after fix:

% Improvement:

Date measured:

Recurrence prevention — what was changed to prevent this from happening again? Documents updated (SOPs, control plans, FMEA, work instructions):

Section 6 — Lessons Learned

What would we do differently if this happened again? Could a similar problem occur in another area? Where?

Report Sign-Off

Author: Date:

Supervisor / Manager: Date:

Quality / Engineering: Date: