SIPOC DIAGRAM

Process/Project Name:
Date:
Prepared By:
Notes:
Suppliers

Provider

Inputs

Input Description

Process

Input Requirements
(optional)

Outputs

Output Description

Output
Requirements
(optional)

Customers
Recipient of Output

See High
Level
Process
Steps Below

Start Boundary:

End Boundary:

dary:

Potential Failure Mode & Effects Analysis

Process/Product:
FMEA Team:
Responsibility:
Prepared By:

Process Steps
Potential
or Product
Failure Mode
Functions

Potential
Effects of
Failure

Severity
(1-10)

Process
Potential
Cause(s) of
Failure

Occurrence
(1-10)

Current
Controls

Detection
(1-10)

Risk Priority
Number
(RPN)

FMEA Date: (original)

(Revised)
Page:

Actions
Recommende Responsibility Action Taken
d Action
and Target
Completion
Date

Revised
Severity
(1-10)

of

Results
Revised
Revised
Occurrence
Detection
(1-10)
(1-10)

Revised Risk
Priority
Number

Potential Failure Mode & Effects Analysis

Process/Product:
FMEA Team:
Responsibility:
Prepared By:

Process Steps
Potential
or Product Failure Mode
Functions

FMEA Date: (original)

(Revised)
Page:

Potential Effects of Failure

Score

Severity
(1-10)

Potential
Cause(s) of
Failure

Process
Occurrence
(1-10)

Current Controls

Detection
(1-10)

Severity Guidelines
AIAG
10 Hazardous without warning
9 Hazardous with warning
8 Very High
7 High
6 Moderate
5 Low
4 Very Low
3 Minor
2 Very Minor

Injure a customer or employee

Be illegal
Render product or service unfit for use
Cause extreme customer dissatisfaction
Result in partial malfunction
Cause a loss of performance which is likely to result in a complaint
Cause minor performance loss
Cause a minor nuisance but can be overcome with no performance loss
Be unnoticed and have only minor effect on performance

1 None

Be unnoticed and not affect the performance

Score

Bad

Good

Occurrence Guidelines
AIAG
10 Very High: Persistent Failures
9 Very High: Persistent Failures
8 High: Frequent Failures
7 High: Frequent Failures
6 Moderate: Occasional Failures
5 Moderate: Occasional Failures
4 Moderate: Occasional Failures
3 Low: Relatively Few Failures
2 Low: Relatively Few Failures

More than once per day

Once every 3-4 days
Once every week
Once per month
Once every 3 months
Once every 6 months
Once per year
Once every 1-3 years
Once every 3-6 years

1 Remote: Failure is Unlikely

Once every 6-9 years

Score

Bad

Good

Detection Guidelines
AIAG
10 Almost Impossible: Absolute certainty of non-detection
9 Very Remote: Controls will probably not detect
8 Remote: Controls have poor chance of detection
7 Very Low: Controls have poor chance of detection
6 Low: Controls may detect
5 Moderate: Controls may detect
4 Moderately High: Controls have a good chance to detect
3 High: Controls have a good chance to detect
2 Very High: Controls almost certain to detect
1 Very High: Controls certain to detect

Defect caused by failure is not detectable

Occasional units are checked for defects
Units are systematically sampled and inspected
All units are manually inspected
Manual inspection with mistake-proofing modifications
Process is monitored (SPC) and manually inspected
SPC is used with an immediate reaction to out of control conditions
SPC as above, 100% inspection surrounding out of control conditions
All units are automatically inspected
Defect is obvious and can be kept from affecting the customer

Bad

Good

Risk Priority Number (RPN)

Recommended Action

Actions
Responsibility and Target Completion
Date

Action Taken

Revised Severity
(1-10)

of

Results
Revised
Revised
Occurrence
Detection
(1-10)
(1-10)

Revised Risk
Priority Number