EN 9136:2018

SLOVENSKI STANDARD
01-julij-2018
Aeronavtika - Analiza izvornih vzrokov in reševanje težav (metodologija 9S)
Aerospace series - Root cause analysis and problem solving (9S Methodology)
Luft- und Raumfahrt - Ursachenanalyse und Problemlösung (9S Methodik)
Série aérospatiale - Analyse de cause racine et résolution de problème (9S
méthodologie)
Ta slovenski standard je istoveten z: EN 9136:2018
ICS:
03.120.01 Kakovost na splošno Quality in general
49.020 Letala in vesoljska vozila na Aircraft and space vehicles in
splošno general
2003-01.Slovenski inštitut za standardizacijo. Razmnoževanje celote ali delov tega standarda ni dovoljeno.

EN 9136
EUROPEAN STANDARD
NORME EUROPÉENNE
May 2018
EUROPÄISCHE NORM
ICS 03.120.10; 49.020
English Version
Aerospace series - Root cause analysis and problem
solving (9S Methodology)
Série aérospatiale - Analyse de cause racine et Luft- und Raumfahrt - Ursachenanalyse und
résolution de problème (9S méthodologie) Problemlösung (9S Methodik)
This European Standard was approved by CEN on 20 November 2017.

CEN members are bound to comply with the CEN/CENELEC Internal Regulations which stipulate the conditions for giving this
European Standard the status of a national standard without any alteration. Up-to-date lists and bibliographical references
concerning such national standards may be obtained on application to the CEN-CENELEC Management Centre or to any CEN
member.
This European Standard exists in three official versions (English, French, German). A version in any other language made by
translation under the responsibility of a CEN member into its own language and notified to the CEN-CENELEC Management
Centre has the same status as the official versions.

CEN members are the national standards bodies of Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia,
Finland, Former Yugoslav Republic of Macedonia, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania,
Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland,
Turkey and United Kingdom.
EUROPEAN COMMITTEE FOR STANDARDIZATION
COMITÉ EUROPÉEN DE NORMALISATION

EUROPÄISCHES KOMITEE FÜR NORMUNG

CEN-CENELEC Management Centre: Rue de la Science 23, B-1040 Brussels
© 2018 CEN All rights of exploitation in any form and by any means reserved Ref. No. EN 9136:2018 E
worldwide for CEN national Members.

Contents Page
European foreword . 3
Rationale . 4
Foreword . 4
Introduction . 5
1 Scope . 6
1.1 General . 6
1.2 Purpose . 6
2 Normative references . 6
3 Terms and definitions . 6
4 General Process . 9
4.1 Basic Principles . 9
4.1.1 Cultural Change . 9
4.1.2 Effective Communication . 10
4.2 When to Apply a Structured Root Cause Analysis and Problem Solving Process . 10
4.3 Process Step Description . 12
5 Process Steps . 14
5.1 Step 0 – Start Immediate Containment Actions . 14
5.2 Step 1 – Build the Team . 16
5.3 Step 2 – Define Problem . 18
5.4 Step 3 – Complete and Optimize Containment Actions . 20
5.5 Step 4 – Identify Root Cause(s) . 21
5.6 Step 5 – Define and Select Permanent Corrective Actions . 23
5.7 Step 6 – Implement Permanent Corrective Action and Check Effectiveness . 24
5.8 Step 7 – Standardize and Transfer the Knowledge Across Business . 26
5.9 Step 8 – Recognize and Close the Team . 27
6 Information and documentation . 29
6.1 Information data definition and documentation. 29
6.2 Forms . 30
6.3 Control of records . 30
(informative) Acronym log . 31
(informative) Information data definition . 32
(informative) Form examples . 48

European foreword
This document (EN 9136:2018) has been prepared by the Aerospace and Defence Industries
Association of Europe - Standardization (ASD-STAN).
After enquiries and votes carried out in accordance with the rules of this Association, this Standard has
received the approval of the National Associations and the Official Services of the member countries of
ASD, prior to its presentation to CEN.
This European Standard shall be given the status of a national standard, either by publication of an
identical text or by endorsement, at the latest by November 2018, and conflicting national standards
shall be withdrawn at the latest by November 2018.
Attention is drawn to the possibility that some of the elements of this document may be the subject of
patent rights. CEN [and/or CENELEC] shall not be held responsible for identifying any or all such patent
rights.
According to the CEN-CENELEC Internal Regulations, the national standards organisations of the
following countries are bound to implement this European Standard: Austria, Belgium, Bulgaria,
Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, Former Yugoslav Republic of Macedonia,
France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta,
Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland,
Turkey and the United Kingdom.
Rationale
The objective of root cause analysis and problem solving is to not only reduce the number of issues
(i.e. undesirable conditions, defects, failures), but to minimize their impact on quality, delivery
performance, costs, and ultimately on the customer. Often big issues originate with small problems that
were discovered too late or were discovered, but were never resolved due to a lack of understanding
the actual issue(s), incorrect analysis of the root cause, and/or ineffective actions being taken.
This guidance document was created to provide a methodology for performing root cause analysis to
resolve a significant or recurrent issue [e.g. quality, On-Time Delivery (OTD), process, documentation),
as guidance within the aviation, space, and defence industry and/or when contractually invoked at any
level of the supply chain.
Foreword
In December 1998, the aviation, space, and defence industry established the International Aerospace
Quality Group (IAQG) with the purpose of achieving significant improvements in quality and reductions
in cost throughout the value stream. This organization, with representation from aviation, space, and
defence companies in the Americas, Asia-Pacific, and Europe and sponsored by SAE International,
Society of Japanese Aerospace Companies (SJAC), and AeroSpace and Defence Industries Association of
Europe -Standardization (ASD-STAN), has agreed to take responsibility for the technical content of this
document to promote best practices that would satisfy associated requirements of Aerospace Quality
Management System (AQMS) standards (i.e. 9100, 9110, 9120).
To assure customer satisfaction, aviation, space, and defence industry organizations must produce and
continually improve safe, reliable products that meet or exceed customer and regulatory authority
requirements. This includes having processes in place to detect and eradicate significant and recurrent
issues. This document standardizes methodology to perform root cause analysis and problem solving to
support these efforts. The establishment of a common methodology, for use by organizations at all
levels of the supply-chain should result in improved action plans and a standardized way of exchanging
information between organizations and external stakeholders (e.g. suppliers, partners, customers,
regulatory agencies).
Introduction
This document has been developed by the IAQG. In accordance with the continual improvement
requirements defined in the 9100-series standards (see Clause 8, “Measurement, Analysis, and
Improvement”), it was deemed useful to promote those industry recognized best practices for
identifying the root causes of nonconformities or undesirable conditions (including potential issues and
conditions) and implementing correction(s) and associated corrective/preventive actions. The process
described in this document was created by comparing and mixing root cause analysis and problem
solving methodologies [e.g. 7 Steps, 8D, Root Cause Corrective Action (RCCA)] used by main actors of
aviation, space, and defence industry.
Unless contractually specified, other root cause analysis processes with slightly different sequencing of
activities and/or different names of process steps may be acceptable, provided that these activities
meet the intent of this document and deliver the same outcomes (i.e. immediate protection, temporary
fix, durable solution, systemic improvement) and provides the same level of information.
Throughout this document, the words “should” and “required” indicate strong recommendations to
apply and correspond to actions that the authors of this document consider important in order to
deliver robust root cause analysis. When strict application of this document is decided by an
organization or is mandated by a customer, they shall be interpreted as an obligation to be complied
with (i.e. interpreted as “shall” and “must”).
1 Scope
1.1 General
The objective of any organization, as part of continual improvement, is to reduce the number of issues
(i.e. undesirable conditions, defects, failures) and to minimize their impact on quality, delivery
performance, and cost.
This includes having processes in place to detect and eradicate significant and recurrent issues, which
implies having well identified problems, a common understanding of their impact and associated root
causes, and having defined and implemented adequate actions so that these problems, including similar
issues will not happen again.
1.2 Purpose
Propose a methodology to improve the way escapes and issues are managed, including communication
between all parties [e.g. engineering, Materials Review Board (MRB), manufacturing, manufacturing
engineering, supplier, customer] to reduce their impact, contain them as far upstream as possible, and
prevent recurrence (i.e. ensure the right measures are taken at the right location and at the right time).
2 Normative references
The following documents are referred to in the text in such a way that some or all of their content
constitutes requirements of this document. For dated references, only the edition cited applies. For
undated references, the latest edition of the referenced document (including any amendments) applies.
EN 9100, Quality Management Systems — Requirements for Aviation, Space and Defence Organizations
EN 9110, Quality Management Systems — Requirements for Aviation Maintenan
...