Root Cause Analysis: Improving Performance for Bottom-Line Results, Fifth Edition
暫譯: 根本原因分析：提升績效以達成底線結果，第五版

這本書全面概述了一個整體且有效的根本原因分析（Root Cause Analysis, RCA）系統的樣貌。從支援基礎設施的設計到對底線效益的衡量，本書提供了實現這一目標的藍圖。雖然傳統上RCA被視為一種反應性工具，作者將展示如何主動應用它，以防止故障的發生。RCA是任何成功的可靠性工程（Reliability Engineering）計畫中的關鍵要素。這些計畫由設備、流程和人員可靠性基礎組成。人員可靠性對於真正的RCA方法的成功至關重要。

本書探討了失敗（不理想的結果）的解剖學以及潛在失敗（高風險）。幾乎所有的失敗都是由人類的遺漏或錯誤行為所引發。本書中描述的方法論適用於任何行業，因為重點在於人類思考事物出錯原因的能力，而不是行業或失敗的性質。本書將可靠性與安全性以及人員表現改善的努力相關聯。作者在理論與實際應用之間提供了良好的平衡，並以案例研究展示底線結果作結。

電子書包含一些彩色圖形。

特點
- 詳細概述有效RCA「系統」的每個方面
- 展示對理解失敗物理學以及人類和系統貢獻的重視
- 演示RCA在全面資產績效管理（Asset Performance Management, APM）系統中的角色
- 探索可靠性工程與安全性之間的相關性
- 將人員表現改善、學習團隊和人為錯誤減少方法的概念整合到RCA中

Mark A. Latino is President of Reliability Center, Inc. (RCI). Mark came to RCI after 19 years in corporate America. During those years, a wealth of reliability, maintenance, and manufacturing experience was acquired. He worked for Weyerhaeuser Corporation in a production role during the early stages of his career. He had an active part in Allied Chemical Corporation's (now Honeywell) Reliability Strive for Excellence initiative that was started in the 1970s to define, understand, document, and live the Reliability culture until he left in 1986. Mark spent 10 years with Philip Morris primarily in a production capacity that later ended in a Reliability Engineering role. Mark is a graduate of Old Dominion University and has a bachelor's degree in business that focused on production and operations management.

Robert J. Latino is CEO of Reliability Center, Inc. (RCI). RCI is a reliability consulting firm specializing in improving equipment, process, and human reliability. He received his bachelor's degree in business administration and man­age­ment from Virginia Commonwealth University.

Robert has been facilitating RCA, FMEA and Opportunity Analyses with his clientele around the world for over 34 years, and has taught over 10,000 students in the PROACT^(R) methodology. He is co-author of numerous seminars and workshops on these topics as well as co-designer of the award winning PROACT^(R) Investigation Management System.

Robert is an author of Patient Safety: The PROACT Root Cause Analysis Approach and contributing author of Error Reduction in Healthcare: A Systems Approach to Improving Patient Safety, The Handbook of Patient Safety Compliance: A Practical Guide for Health Care Organizations and Nurse Communication: Safe Care, Positive Workplaces, & Rewarding Careers.

Robert has also published a paper entitled, "Optimizing FMEA and RCA Efforts in Healthcare" in the ASHRM Journal and presented a paper entitled, "Root Cause Analysis Versus Shallow Cause Analysis: What's the Difference?" at the NAHQ National Conference. He has been published in numerous trade magazines on the topic of reliability, FMEA, and RCA and is also a frequent speaker on the topic at domestic and international trade conferences.

Robert has also applied the PROACT methodology to the field of Terrorism and Counter Terrorism via a published paper entitled, "The Application of PROACT RCA to Terrorism/Counter Terrorism Related Events."

Kenneth C. Latino is an Asset Performance Management (APM) Product Manager with GE Digital. He has a Bachelor of Science degree in computerized information systems from Virginia Commonwealth University. He began his career developing and maintaining maintenance software applications in the continuous process industries. After working with clients to help them become more proactive in their maintenance activities, he began consulting and teaching industrial plants how to implement reliability methodologies and techniques to help improve the overall performance of plant assets. Prior to his current role at GE, Kenneth was the Reliability Engineering Manager at the WestRock paper mill in Covington Mill.

Over the past few years, a majority of Kenneth's focus has centered around developing reliability approaches with a heavy emphasis on Asset Performance Management (APM) with specific focus around failure elimination and Root Cause Analysis (RCA). In the course of his career, he has trained thousands of engineers and technical representatives on how to implement a successful RCA strategy at their respective facilities. He has co-authored two RCA training courses: one for engineers and another for hourly personnel.

Kenneth is also co-software designer of the RCA software solution entitled the PROACT Investigation Management System. The PROACT solution is used by hundreds of companies around the world every day to understand the causes of failures to help eliminate/mitigate their reoccurrence.

馬克·A·拉蒂諾是可靠性中心公司（Reliability Center, Inc.，簡稱 RCI）的總裁。馬克在美國企業界工作了19年後來到 RCI。在這些年中，他積累了豐富的可靠性、維護和製造經驗。他在職業生涯的早期階段曾在韋爾哈瑟公司（Weyerhaeuser Corporation）擔任生產角色。他積極參與了聯合化學公司（Allied Chemical Corporation，現為霍尼韋爾）於1970年代啟動的可靠性卓越追求（Reliability Strive for Excellence）計劃，該計劃旨在定義、理解、記錄並實踐可靠性文化，直到他在1986年離開。馬克在菲利普·莫里斯（Philip Morris）工作了10年，主要擔任生產職位，後來轉為可靠性工程角色。馬克畢業於老道明大學（Old Dominion University），獲得專注於生產和運營管理的商業學士學位。

羅伯特·J·拉蒂諾 是可靠性中心公司（Reliability Center, Inc.，簡稱 RCI）的首席執行官。RCI是一家專注於提高設備、流程和人員可靠性的可靠性諮詢公司。他在維吉尼亞聯邦大學（Virginia Commonwealth University）獲得商業管理學士學位。

羅伯特在全球範圍內為客戶提供根本原因分析（RCA）、失效模式與影響分析（FMEA）和機會分析的服務已超過34年，並在PROACT^(R)方法論中教授了超過10,000名學生。他是多個相關主題研討會和工作坊的共同作者，也是獲獎的PROACT^(R)調查管理系統的共同設計者。

羅伯特是《病人安全：PROACT根本原因分析方法》（Patient Safety: The PROACT Root Cause Analysis Approach）的作者，並且是《醫療保健中的錯誤減少：改善病人安全的系統方法》（Error Reduction in Healthcare: A Systems Approach to Improving Patient Safety）、《病人安全合規手冊：醫療機構的實用指南》（The Handbook of Patient Safety Compliance: A Practical Guide for Health Care Organizations）以及《護理溝通：安全護理、積極工作場所與有意義的職業生涯》（Nurse Communication: Safe Care, Positive Workplaces, & Rewarding Careers）的貢獻作者。

羅伯特還在《ASHRM期刊》中發表了一篇題為《優化醫療保健中的FMEA和RCA工作》（Optimizing FMEA and RCA Efforts in Healthcare）的論文，並在NAHQ全國會議上發表了一篇題為《根本原因分析與淺層原因分析：有何不同？》（Root Cause Analysis Versus Shallow Cause Analysis: What's the Difference?）的論文。他在多本行業雜誌上發表了有關可靠性、FMEA和RCA的文章，並且經常在國內外的行業會議上發表演講。

羅伯特還將PROACT方法論應用於恐怖主義和反恐領域，發表了一篇題為《PROACT RCA在恐怖主義/反恐相關事件中的應用》（The Application of PROACT RCA to Terrorism/Counter Terrorism Related Events）的論文。

肯尼斯·C·拉蒂諾 是GE Digital的資產績效管理（Asset Performance Management，簡稱 APM）產品經理。他擁有維吉尼亞聯邦大學的計算機資訊系統理學學士學位。他的職業生涯始於開發和維護連續流程行業的維護軟體應用程式。在與客戶合作幫助他們在維護活動中變得更加主動之後，他開始諮詢並教導工業廠房如何實施可靠性方法論和技術，以幫助改善廠房資產的整體績效。在GE之前，肯尼斯曾擔任Covington Mill的WestRock紙廠的可靠性工程經理。

在過去幾年中，肯尼斯的主要焦點集中在開發可靠性方法，特別強調資產績效管理（APM），並專注於消除故障和根本原因分析（RCA）。在他的職業生涯中，他培訓了數千名工程師和技術代表，教導他們如何在各自的設施中實施成功的RCA策略。他共同編寫了兩個RCA培訓課程：一個針對工程師，另一個針對時薪人員。

肯尼斯還是名為PROACT調查管理系統的RCA軟體解決方案的共同設計者。PROACT解決方案每天被全球數百家公司使用，以了解故障原因，幫助消除/減輕其再次發生。