ESSAY Root Cause Analysis: Integrating Orgtology’s Hypothesis 2X with Established RCA Tools By Derek Hendrikz - Originator of Orgtology Principal Orgtologist - OrgXpert Consulting (http://orgxpert.com) Senior Lecturer – UNIORG (http://uniorg.education) Conceptual Architect – OrgSmart Business Intelligence Systems (http://orgsmartapp.com) Chairperson: Council of Elders – International Orgtology Institute (http://orgtology.org) Correspondance: derek@orgxpert.com Abstract This essay presents an integrated root-cause analysis (RCA) methodology that embeds Orgtology’s Hypothesis 2X. This hypothesis asserts that every organizational phenomenon unfolds across concrete algorithmic and abstract dynamic dimensions (Hendrikz, 2020). The methodology is structured into five established RCA stages: The methodology consists of five stages: Stage 1 reframes the problem using a dual-lens 4W1H approach; Stage 2 utilizes both 2X Fishbone and 2X Matrix diagrams to map out both technical and human drivers; Stage 3 implements a quantitative 2X risk assessment to prioritize causes; Stage 4 involves alternating concrete and abstract 2X-5-Why drills; and Stage 5 creates paired interventions with distinct concrete and abstract success metrics. Keywords Orgtology, Hypothesis 2X, dual-lens analysis, root cause analysis, RCA, 2X Fishbone, 2X Matrix, 2X-5-Why, 4W1H, 5W1H, 2X risk assessment, 2X interventions, Ishikawa Fishbone Introduction This integrated root cause analysis methodology emphasizes the importance of understanding both the technical and human factors involved in organizational failures, integrating advanced techniques for a more effective root cause analysis. When a production line grinds to a halt, managers often spotlight mechanical failure, yet the root cause usually straddles both tangible processes and intangible dynamics. Orgtology, first articulated by Hendrikz in 2018, rests on a single foundational assumption, what he termed Hypothesis 2X. The hypothesis implies that every organizational phenomenon unfolds along two inseparable dimensions: a concrete, algorithmic side and an abstract, dynamic side (Hendrikz, 2020). The concrete dimension comprises algorithmic, rule-based elements such as defined workflows, system configurations, and performance metrics. These are things that we can control, predict and quantify. In contrast, the abstract dimension encompasses relational dynamics, beliefs, motivations, and goal-driven behaviours. These factors are emergent, context-dependent, and resistant to precise measurement. By insisting on this dual-lens perspective, orgtology ensures that any RCA will fully reconcile the mechanistic flow of activities with the complex patterns of human behaviour that drive outcomes. Root Cause Analysis (RCA) has traditionally drawn on tools such as the Ishikawa “fishbone” diagram, the 5-Why technique and the 5W1H interrogatives to move beyond surface symptoms and address underlying causes (Ishikawa, 1982; Ohno, 1988). Orgtology’s Hypothesis 2X framework enhances these established methods by insisting that every organisational failure possesses both a concrete (algorithmic) dimension and an abstract (dynamic) dimension (Hendrikz, 2025). By deliberately pairing algorithmic-like process gaps with the human dynamics that drive them, Hypothesis 2X prevents a one-sided diagnosis, whether purely technical or purely behavioural. This dual-focus approach builds on earlier continuous-improvement insights into the interplay between technical processes and human factors, as explored by Deming and Imai in the 1980s (Deming, 1986; Imai, 1986). To guide the reader through each phase of analysis, the essay unfolds in five stages, namely: framing, defining, prioritisation, decision, and intervention. Each examined through the lens of Hypothesis 2X. Thus, effective root cause analysis requires a comprehensive evaluation of both concrete processes and the abstract dynamics that influence them. This analysis is crucial for identifying both technical and abstract root causes, essential for implementing comprehensive and sustainable remedies. The concrete dimension includes algorithmic and rule-based elements, allowing for control, prediction, and quantification. The abstract dimension, however, covers relational dynamics, beliefs, motivations, and behaviors that are more fluid and context-dependent. This dual-lens perspective ensures that any RCA comprehensively addresses both mechanical processes and the complex human behaviors influencing outcomes. In the context of root cause analysis, recognizing these dual dimensions can significantly enhance the outcome of any investigation. This integrated approach allows for a deeper understanding of both the tangible and intangible factors influencing organizational performance. The concrete dimension involves algorithmic, rule-based elements that we can control, predict, and quantify. In contrast, the abstract dimension encompasses relational dynamics, beliefs, motivations, and goal-driven behaviors that are emergent and context-dependent. This dual-lens perspective ensures that any RCA fully reconciles the mechanistic flow of activities with the complex patterns of human behavior that drive outcomes. Thus, effective root cause analysis requires a comprehensive evaluation of both concrete processes and the abstract dynamics that influence them. The evolution of root cause analysis has led to methods like the 2X framework, which brings depth to traditional approaches. Combining these perspectives enriches the root cause analysis process, allowing organizations to pinpoint issues more accurately and implement effective solutions. Stage 1: FRAMING the problem through Hypothesis 2X and 4W1H Root cause analysis should always take into account both the measurable factors and the less tangible elements that affect performance. A precise problem statement is the foundation of any rigorous RCA (Bicheno & Holweg, 2009). Hypothesis 2X mandates exploring each diagnostic question “What, Where, When, Who, and How”, through two interdependent lenses: Concrete lens: examines the observable process and procedural deviations, policy, or rule breaches, timings, locations, actors, and specific actions that led to the problem. Abstract lens: uncovers the underlying relational dynamics, values, beliefs, perceptions, assumptions and cultural and behavioural patterns that shaped or obscured the problem. This dual lens in root cause analysis ensures that interventions are not only targeted but also sustainable in the long term. This bifurcated approach ensures that teams avoid the trap of “fixing the code and ignoring culture” or “rallying the troops but overlooking process flaws” (Hendrikz, 2025). In the 2X Frame below we work with a hypothetical problem of: “Order fulfilment lead times spiked 35% last quarter”. 4W1HConcreteAbstractWhat?The order-consolidation step in the WMS was skipped for 45% of orders, fragmenting pick runs.Staff believed skipping consolidation would speed fulfilment, even though it created inefficiencies.Where?In the East-Region warehouse (Dock B), orders were rerouted to an ad-hoc packing line.East-Region teams view Dock B as understaffed and low-priority, so process standards slip there.When?Daily between 14:00 and 16:00, during the afternoon shift handover, bypasses peaked.Supervisors tacitly endorse shortcuts during shift changes to hit daily output targets.Who?Afternoon pick teams, especially temporary agency workers, bypassed the automated batching rule.Agency staff, eager to prove themselves, felt unclear on accountability and thus overrode controls.How?By manually toggling the “batch release” flag in the system UI, bypassing buffer-check logic.A culture that rewards individual throughput normalized manual overrides as acceptable practice. The 4W1H technique asks a “How” and all the “W” questions, except “Why”, which we use later to deepen the analysis. Through framing a problem through the 4W1H - 2X Frame, you learn to understand both, the algorithmic and dynamic context of the problem. Stage 2: DEFINING the Root Cause through a 2X Fishbone Diagram or a 2X Matrix Hendrikz introduced the 2X fishbone in 2025 to visualise dual-lens causality (Hendrikz, 2025). The upper half captures concrete drivers (mathematical, mechanical, quantifiable), while the lower half captures abstract drivers (intangible, random, dynamic). This split-screen view helps the analyst to detect and correct unbalanced maps, where participants focus too heavily on one dimension, and steer them towards truly holistic analyses. Through the 2X Fishbone, one would analyse the 4W1H - 2X Frame to come up with a balanced view of possible root causes, as shown in the respective “concrete” and “abstract” tables below. For instance, a thorough root cause analysis will reveal that both human behavior and technical systems must be aligned for successful outcomes. Possible CONCRETE Root Causes Machines/Systems:Outdated WMS lacking API-level integration.Fragmented System UI modules with inconsistent UX.Point-solution islands (e.g. separate picking and packing).Efficiency:Manual batch processing creating delays.Unbalanced task distribution across zones.High setup/changeover times between runs.Knowledge & Skills:Insufficient training on new UI and workflows.Undefined competency standards for operators.No coaching or mentoring programs.Resources:Chronic understaffing in peak shifts.Lack of automation tools (scanners, conveyors).Budget constraints delaying hardware upgrades.Rules:No formalized inventory-reorder policyInformal, ad-hoc SOPs stored in local PCsNo version control or regular review of policies Possible ABSTRACT Root Causes UnderstandingTechnical staff do not know where to find end-to-end process flows. It is not clear to staff which specific process steps apply to which roles. Staff do not know what the shared metrics are for throughput and accuracy.ImpactCustomer dissatisfaction, complaints, and lost business.Performance Decline: A 35% increase suggests a major slowdown in operations.Quality defects going undetected until final stage.CultureResistance to digitization (“that’s how we’ve always done it”).Blame-oriented mindset discouraging error reporting.Minimal emphasis on continuous improvement.RelationshipsSiloed teams with minimal hand-off coordination.Undefined escalation paths for exception handling.No cross-functional governance forum.PESTLERegulatory updates (e.g. new safety standards) not embedded in processesFluctuating exchange rates hindering IT capital planningPolitical shifts disrupting key supplier networks Where both human dynamics and technical failures must be examined, the 2X Fishbone delivers a dual‐lens analysis that surfaces process faults alongside relational and cultural enablers (Hendrikz, 2025). When the issue is purely technical, however, the classic Ishikawa Fishbone suffices, offering frontline teams a streamlined diagnostic focused on machinery, materials, and methods (Ishikawa, 1985). As a result, the 2X Fishbone is best employed by managerial and supervisory staff charged with addressing systemic people‐and‐process interactions, whereas the Ishikawa Fishbone empowers technical operators to resolve equipment and workflow errors more rapidly - particularly since human‐centric problems typically demand longer‐term cultural and behavioural interventions than purely mechanical fixes. When a root cause appears to be rooted in human dynamics, the 2X Matrix provides an alternative framework. It repurposes the same five concrete and five abstract dimensions of the 2X Fishbone into a 5 × 5 grid, aligning the concrete categories along the top axis with the abstract lenses down the side. Each cell is then populated with a concise, consolidated root‐cause statement that reveals how specific operational elements interact with underlying abstract dynamics. The example below illustrates this consolidated matrix approach… Thus, effective training on root cause analysis enhances both technical skills and fosters a culture of continuous improvement. Mapping the 2X Matrix To illustrate the efficacy of the 2X approach in root cause analysis, organizations can examine case studies where both dimensions were successfully integrated. CONCRETE → ABSTRACT ↓ Machines/ SystemsEfficiencyKnowledge & SkillsResourcesRulesUnderstandingFragmented WMS and UI obscure end-to-end process visibility.No baseline throughput metrics makes performance unclear.Undefined competency standards cloud role expectations.Absence of forecasting tools hides peak-shift gaps.Decentralized SOPs fail to clarify which procedures apply.ImpactLegacy systems miss validation errors, triggering SLA breaches.Manual batch delays drive repeated rework and cost overruns.Skill gaps produce quality defects detected too late.Understaffing causes order backlogs, hurting revenue targets.Ad-hoc policies yield inconsistent fulfilment, eroding trust.CultureResistance to WMS upgrades stalls system improvementsThroughput-at-all-cost mindset normalizes process shortcuts.Lack of a mentoring culture impedes knowledge transfer.Cost-cutting staffing norms undervalue adequate shift coverage.Complacent attitude toward informal SOPs undermines discipline.RelationshipsPoor integration between WMS/UI and adjacent systems.Siloed zone operations prevent cross-functional handoffs.No peer-coaching networks block skill sharing.HR and operations misalignment delays critical staffing decisions.Absence of governance forums fails to align process rules.PESTLECybersecurity and tech-policy updates not reflected in WMS roadmap.Budgetary pressure limits investment in automation.Talent-market volatility complicates training pipeline.Supply-chain disruptions restrict availability of key tools.Regulatory changes aren’t embedded in formal policies. Stage 3: PRIORITISING root causes through a 2X Risk Analysis When a 2X Fishbone or 2X Matrix produces dozens of candidate root causes, conducting a full 5-Why drill on each becomes impractical. For example, 30 causes × 5 why’s = 150 “why” questions. This is an effort few teams will sustain once they believe they “know enough” to act. Instead, we first prioritise the defined root causes with the 2X risk analysis technique, then apply 5-Why only to the highest‐exposed causes. To prioritise a long list of identified root causes, the first step is to list all the defined root cause items in a 2X risk analysis table. The table will have the following headings: (1) the defined root cause, (2) quantified probability, (3) quantified impact, (4) quantified risk value, (5) quantified mitigative ability, (6) quantified continuity ability, (7) quantified control value, and (8) quantified risk exposure. Problem:Probability:Impact:Risk:Mitigation:Continuity:Control:Exposure:Decentralized SOP’s fail to clarify which procedures apply..75.65.49.70.75.53-.04 From an orgtology perspective, every risk comprises of two inseparable dimensions (Hendrikz, 2018). In line with Hypothesis 2X, the Inherent Risk is an abstract dimension, which reflects what lies beyond our direct control (e.g., probability of occurrence and potential impact). Contrarywise, our ability to Control the Risk is a concrete dimension, which captures our capacity to influence or contain that risk (through mitigation measures and continuity planning). Because Inherent Risk is essentially fixed, the only way to reduce overall exposure is to raise our Control capability. Formally, a 2X risk analysis is calculated as follows: Inherent Risk Value (IRV) = Probability × Impact Risk Control Value (RCV) = Mitigation × Business Continuity Risk Exposure Value (REV) = IRV – RCV A negative or zero REV indicates that existing controls outweigh the inherent threat, in which case no further action is required. A positive REV flags gaps that demand new or strengthened controls. To ensure consistency across dozens of risks, quantify each input on a 0.01 to 0.99 scale by first assigning a 1 to 5 rating, then converting it to a 1 to 99 range: 1 (Very Low) = 1–20 2 (Low) = 21–40 3 (Medium) = 41–60 4 (High) = 61–80 5 (Very High) = 81–99 For example, rating a risk’s Impact as “High” obliges you to select a precise value between 61 and 80, which translates to 0.61–0.80. This two-stage approach forces granularity, enabling you to calculate, rank, and focus on the top five exposures with clarity and precision. This 2X Risk Assessment technique could be used accurately to prioritise root causes identified in the 2X Fishbone or the 2X Matrix as shown in the table below… RankRoot CauseProbabilityImpactIRVMitigationContinuityRCVREV1Understaffing causes order backlogs, hurting revenue targets.0.850.750.640.500.600.300.342Throughput-at-all-cost mindset normalizes process shortcuts.0.750.700.530.550.600.330.203Poor integration between WMS/UI and adjacent systems.0.700.750.530.600.550.330.204Manual batch delays drive repeated rework and cost overruns.0.780.700.550.600.650.390.165No baseline throughput metrics make performance unclear.0.720.700.500.600.600.360.146Complacent attitude toward informal SOPs undermines discipline.0.550.650.360.450.550.250.117Decentralized SOPs fail to clarify which procedures apply.0.780.750.590.700.700.490.108Lack of a mentoring culture impedes knowledge transfer.0.480.580.280.350.500.180.109Legacy systems miss validation errors, triggering SLA breaches.0.850.800.680.780.750.590.1010Absence of forecasting tools hides peak-shift gaps.0.520.600.310.400.550.220.0911Fragmented WMS and UI obscure end-to-end process visibility.0.800.850.680.750.800.600.0812Undefined competency standards cloud role expectations.0.500.650.330.500.500.250.0813Siloed zone operations prevent cross-functional handoffs.0.400.600.240.400.400.160.0814HR and operations misalignment delays critical staffing decisions.0.450.550.250.350.500.180.0715Skill gaps produce quality defects detected too late.0.600.650.390.600.580.350.0416Absence of governance forums fails to align process rules.0.430.600.260.500.450.230.0317No peer-coaching networks block skill sharing.0.580.600.350.550.600.330.0218Resistance to WMS upgrades stalls system improvements.0.630.650.410.700.600.42–0.0119Ad-hoc policies yield inconsistent fulfilment, eroding trust.0.650.680.440.800.600.48–0.0420Cost-cutting staffing norms undervalue adequate shift coverage.0.380.550.210.700.400.28–0.07 IRV = Probability × Impact RCV = Mitigation × Continuity REV = IRV − RCV Stage 4: DECISION on what action to take through 2X-5-Why Drills Taiichi Ohno, the father of the Toyota Production System (TPS), originally popularized the Five Why’s technique. Traditional 5W1H exercises ask Who, What, When, Where, Why and How, while the Five Why’s technique iterates “Why?” five times to peel back symptom layers (Serrat, 2017). In line with Hypothesis 2X, a 2X-5-Why drill will alternate four “Why’s?” between concrete and abstract perspectives. The last “Why” will be a hybrid. This method produces richer and more holistic causal chains. In the previous 2X risk analysis, there were three root causes that had a negative value, meaning that they need no further attention. In so, from 20 defined root causes, 17 need further attention. One has two options here. The one is to deepen the enquiry with the 5-Why technique on all the mentioned 17 root causes. The other option is to focus on the top five identified root causes. If that does not eliminate the problem, then drill deeper down. From the 2X risk analysis, following is a 2X-5-Why analysis drill of the highest-ranking root cause - “Understaffing causes order backlogs, hurting revenue targets.” We alternate between concrete and abstract questions, finishing with a hybrid “why” that bridges both dimensions. It makes sense to begin with a concrete answer because a ‘first’ abstract answer might project the enquiry not a subjective direction. Why #DimensionQuestionAnswer1ConcreteWhy is the afternoon shift chronically understaffed?Because several picker and packer positions have been vacant for over three months.2AbstractWhy have those vacancies remained open so long?Because leadership views warehouse headcount primarily as a cost to minimize, not as a capacity enabler.3ConcreteWhy do managers treat staffing purely as a cost?Because performance metrics focus on labour spend reduction rather than on throughput or backlog reduction.4AbstractWhy do the company’s performance metrics emphasize cost over capacity?Because the organizational culture prioritizes short-term financial targets and underweights long-term growth.5HybridWhy is there no mechanism to balance labour investment with fulfilment throughput goals?Because there’s no cross-functional governance forum linking finance, HR, and operations to align metrics. Decision regarding the True Root Cause The absence of a cross-functional governance forum prevents integration of financial, HR, and operational metrics, leading to understaffing and resultant backlogs. Through the 2X-5-Why drill, each chain yields a micro root-cause, some purely algorithmic, others purely cultural, ending with a bridging hybrid. By deliberately switching lenses, this layered drill uncovers both data-driven failures and the human currents behind them (Hendrikz, 2025; Deming, 1986). Stage 5: Designing 2X INTERVENTIONS Single-track fixes often fail to endure (Deming, 1986). The 2X intervention pairs a concrete structural plan with an abstract behavioural framework to address the absence of a cross-functional forum that integrates financial, HR, and operational metrics, thereby alleviating understaffing and order backlogs. DimensionIntervention StepsSuccess MetricsTimelineOwnerConcreteEstablish a Cross-Functional Governance Forum with reps from Finance, HR & Operations.Define and deploy an integrated dashboard template combining headcount forecasts, budget variances & throughput metrics.Schedule bi-weekly forum meetings; assign RACI roles (responsible, accountable, consultative, and informed) for each metric owner.Forum attendance ≥ 90%.Integrated dashboard published on schedule ≥ 95% of meetings.Time to fill picker/packer vacancies reduced by 20%.Forum chartered within 4-weeks.Full dashboard roll-out in 3-months.COO & HR DirectorAbstractLaunch quarterly “Integration Mindset” workshops grounded in systems-thinking (Senge, 1990).Revise the performance metrics framework to include a Cross-Functional Alignment Index (CFAI).Deploy a monthly pulse survey measuring perceived metric coherence and forum effectiveness.Workshop satisfaction score ≥ 4.0/5.CFAI ≥ 0.75 (0–1 scale).Pulse-survey mean coherence rating ≥ 4.0/5Workshops begin in 8 weeks.CFAI live in 4-months.CHRO & L&D Lead This two-pronged strategy ensures that technical guardrails last and behavioural shifts stick. Conclusion Orgtology’s Hypothesis 2X elevates RCA from a linear, symptom-focused exercise to a dynamic, dual-lens inquiry. By integrating dual-frame problem statements, 2X fishbone diagrams, and 2X Matrix, alternating 2X-5-Why drills, 2X risk assessment, and 2X interventions, organizations will avoid one-dimensional remedies, leading to a more comprehensive understanding of root cause analysis. This integrated approach not only uncovers richer root-cause insights but also designs solutions that endure. In so, technical fixes are reinforced by behavioural shifts. As the originator of orgtology and Hypothesis 2X, and the developer of a myriad of 2X RCA tools, Hendrikz (2025) posits that this methodology redefines RCA excellence, offering a game-changing paradigm for continuous improvement, risk mitigation, and enduring operational resilience. References Bicheno, J., & Holweg, M. (2009). The Lean Toolbox: The essential guide to Lean transformation (4th ed.). Buckingham: PICSIE Books. 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Guide to Quality Control (2nd rev. English ed.). Tokyo: Asian Productivity Organization. Ishikawa, K. (1985) What Is Total Quality Control? The Japanese Way. Englewood Cliffs, NJ: Prentice-Hall. Ohno, T. (1988). Toyota Production System: Beyond Large-Scale Production. Cambridge, MA: Productivity Press. Senge, P. M. (1990). The fifth discipline: The art and practice of the learning organization. New York, NY: Doubleday/Currency. Serrat, O. (2017). The Five Whys Technique, in Serrat, O. (ed.) Knowledge Solutions: Tools, Methods and Approaches to Drive Organizational Performance. Singapore: Springer. This integrated approach not only uncovers richer root-cause insights but also designs solutions that endure. As the originator of orgtology and Hypothesis 2X, Hendrikz (2025) posits that this methodology redefines RCA excellence, offering a game-changing paradigm for continuous improvement, risk mitigation, and enduring operational resilience through effective root cause analysis. This integrated approach not only reveals deeper insights into root causes but also creates enduring solutions. Hendrikz (2025), as the originator of orgtology and Hypothesis 2X, argues that this methodology redefines excellence in RCA, facilitating continuous improvement, risk management, and long-term operational resilience through effective root cause analysis.
