• Jimmy Martin-Delgado, Alba Martínez-García, Jesús María Aranaz, José L Valencia-Martín, and José Joaquín Mira.
• Atenea Investigation Group, Fundación para el Fomento de la Investigación Sanitario y Biomédica de la Comunidad Valenciana (FISABIO), Valencia, Spain, jimmy.martind@umh.es.
• Med Princ Pract. 2020 Jan 1; 29 (6): 524-531.

ObjectivesThe aim of this systematic review was to consolidate studies to determine whether root cause analysis (RCA) is an adequate method to decrease recurrence of avoidable adverse events (AAEs).MethodsA systematic search of databases from creation until December 2018 was performed using PubMed, Scopus and EMBASE. We included articles published in scientific journals describing the practical usefulness in and impact of RCA on the reduction of AAEs and whether professionals consider it feasible. The Mixed Methods Appraisal Tool was used to assess the quality of studies.ResultsTwenty-one articles met the inclusion criteria. Samples included in these studies ranged from 20 to 1,707 analyses of RCAs, AAEs, recommendations, audits or interviews with professionals. The most common setting was hospitals (86%; n = 18), and the type of incident most analysed was AAEs, in 71% (n = 15) of the cases; 47% (n = 10) of the studies stated that the main weakness of RCA is its recommendations. The most common causes involved in the occurrence of AEs were communication problems among professionals, human error and faults in the organisation of the health care process. Despite the widespread implementation of RCA in the past decades, only 2 studies could to some extent establish an improvement in patient safety due to RCAs.ConclusionsRCA is a useful tool for the identification of the remote and immediate causes of safety incidents, but not for implementing effective measures to prevent their recurrence.© 2020 The Author(s) Published by S. Karger AG, Basel.

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