Draft a clear problem statement based on mutual agreement of all staff responsible for productivity in the blood bank department. Investigate to determine when the problem occurred and if it is continuing. Be as specific as possible about the problem that has occurred. Write the problem statement on the right side of your paper, at the head of the "fish." Your team will work out and away from this problem. Draw a line with an arrow toward the head of the fish—this is the fish's "backbone. In our example, the problem identified is "Blood Bank Productivity is down 20% in July" based on labor minutes per reportable test (LM/RT) data for the month. Figure 1 describes the problem.
