Root Cause Analysis, 4th Edition

Preserving Event Data 123

talk to rst should typically be the physical observers or witnesses to the event.

Efforts to obtain such interviews should be relentless and immediate. We risk the

chance of losing direct observation when we interview observers days after an event

occurs. We will ultimately lose some degree of short-term memory and also risk

the observers having talked to others about their opinion of what happened. Once

observers discuss such an event with another outsider, they will tend to reshape their

direct observation with the new perspectives.

We have always identied the goal of an interview with an observer to ...