{"id":35376,"date":"2018-04-17T11:32:02","date_gmt":"2018-04-17T11:32:02","guid":{"rendered":"https:\/\/kepner-tregoe.com\/resources\/white-papers\/oil-refinery-avoids-shut-down-through-structured-root-cause-analysis\/"},"modified":"2026-01-13T15:44:28","modified_gmt":"2026-01-13T15:44:28","slug":"oil-refinery-avoids-shut-down-through-structured-root-cause-analysis","status":"publish","type":"white-paper","link":"https:\/\/kepner-tregoe.com\/zh-hans\/resources\/whitepapers\/oil-refinery-avoids-shut-down-through-structured-root-cause-analysis\/","title":{"rendered":"Oil Refinery Avoids Shut Down Through Structured Root Cause Analysis"},"content":{"rendered":"\n<h4 class=\"wp-block-heading p1\" id=\"h-and-saves-millions\">And saves millions<\/h4>\n\n\n\n<h4 class=\"wp-block-heading p1\" id=\"h-lonnie-wilson-author-of-the-lean-classic-how-to-implement-lean-manufacturing-offers-a-case-study-of-real-life-problem-solving-that-saved-millions-of-dollars-and-then-a-deeper-dive-into-troubleshooting-methods-while-the-case-study-is-specific-to-a-lean-refining-situation-both-the-case-study-and-overview-of-root-cause-analysis-offer-insights-that-are-relevant-across-technologies-processes-and-industries\">Lonnie Wilson, author of the Lean classic, <em>How to Implement Lean Manufacturing<\/em>, offers a case study of real-life, problem solving that saved millions of dollars, and then a deeper dive into troubleshooting methods. While the case study is specific to a Lean, refining situation, both the case study and overview of root cause analysis, offer insights that are relevant across technologies, processes and industries.<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-nbsp\">\u00a0<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-the-background\">The Background<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Recently I was working with a group of greenbelts who were part of their refinery\u2019s Lean-Sigma (LS) program; I was their program advisor and mentor.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">On one visit, I was approached by the Refinery Manager. He advised me they were headed for an unscheduled shutdown of the cat cracker because the VGO desulfurizer was prematurely reaching end of run (EOR) catalyst conditions.\u00a0 It seems the feed-effluent (F\/E) exchangers were fouling at an unprecedented rate and a premature and very expensive shutdown was imminent.\u00a0 Knowing I was familiar with Kepner-Tregoe problem solving methods, he asked that we look at this problem and see if we could avoid the unscheduled shutdown he anticipated.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">I spoke to the LS Program Manager and he arranged for the appropriate group to meet the next day.\u00a0 They were advised to block out the entire day. The next morning, 7:30 sharp, we started.\u00a0 They came with charts, tables and graphs galore; the volume of data they had gathered and compiled was truly impressive. \u00a0The Program Manager and I came with a problem specification template.\u00a0 We went through introductions,\u00a0 I said a quick word about the method we were going to use, and we started.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-the-technical-issue\">The Technical Issue<\/h4>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\">People have told me numerous times that a problem well-defined is 50% solved. Rather I find that a problem well-defined is more likely 90% solved, and I have seen no process to define problems that even approaches the KT methodology.<\/p>\n<\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\">I asked the lead process engineer to give me a recap of the history so I would be somewhat up to speed with the rest of the group.\u00a0 He said, \u201cFormany years the fouling rate in the F\/E exchangers was used as an early indicator for catalyst EOR conditions in this reactor. During most of the run, the reactor top bed pressure drop (DP) would show very little change. However, normally eight to ten months into the run, these heat exchangers would reach minimum efficiencies and we knew a shutdown was imminent.\u00a0 Shortly after reaching minimum efficiencies, the top bed pressure drop would increase dramatically; forcing the shutdown.\u00a0 Maximum top bed pressure drop was normally reaching in three to four months. When we shutdown we would skim the reactor top bed and do partial cleaning of the heat exchanger.\u00a0 This would extend the run to the next major shutdown.\u00a0 Due to a variety of issues, including safety, environmental and economic, the top bed skim option is no longer available.\u00a0 On the last shutdown we made several process changes including: improved water wash facilities; instrumentation and piping changes; and, because we were purchasing lower sulfur crudes, we loaded the reactor with a slightly less active and cheaper catalyst.\u00a0 These changes were designed to allow an 18-month uninterrupted run.\u00a0 However, now we are at seven months into the run and, with very low exchanger efficiencies, are facing an unscheduled shutdown within the next three to five months.\u00a0 We started this run in August and although we did not see it initially, due to our monitoring practices, heat exchanger efficiency dropped significantly.\u00a0 By November we were concerned and put this team together to revisit this issue.\u00a0 Now, five months later, heat exchanger efficiencies are at a minimum, but we have not seen the expected changes in reactor DP.\u00a0 We have invested over 100 man-days of engineering time and we are beginning to think we might not understand this problem\u201d.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">I asked that he explain the mechanism that causes the reactor DP to rise, causing the shutdown.\u00a0\u00a0 He went on:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cThe reactor feed is on the tube-side; reactor effluent is on the shell-side of the exchangers.\u00a0 The reaction is exothermic, so the reactor effluent is used to preheat the reactor feed.\u00a0 We get tube-side fouling reducing the exchanger efficiency.\u00a0 When the exchanger reaches a minimum efficiency, we believe the debris is then carried into the reactor rather than plating out on the exchangers.\u00a0 The DP on the top bed then rises causing the end of the run.\u00a0 We have seen this on the last four runs since the major modifications seven years ago.\u201d<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"723\" height=\"365\" src=\"https:\/\/kepner-tregoe.com\/wp-content\/uploads\/2025\/07\/iStock-1302741705-e1633726531966-9.jpg\" alt=\"\" class=\"wp-image-35452\" srcset=\"https:\/\/kepner-tregoe.com\/wp-content\/uploads\/2025\/07\/iStock-1302741705-e1633726531966-9.jpg 723w, https:\/\/kepner-tregoe.com\/wp-content\/uploads\/2025\/07\/iStock-1302741705-e1633726531966-9-300x151.jpg 300w\" sizes=\"auto, (max-width: 723px) 100vw, 723px\" \/><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-the-problem-solving-session\">The Problem-Solving Session<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Everyone then spent another 30 minutes scouring over the data.\u00a0 We then began to fill out the problem specification.\u00a0 At first it went slowly as everyone wanted to chase their favorite rabbit.\u00a0 Once we got the discipline to take it one step at a time, we moved quickly.\u00a0 Long before lunch we had specified the problem well enough that now everyone was convinced that, although they did not understand this mechanism, it surely was different from what they had previously seen.\u00a0 We started to break for lunch; but no one wanted to stop the brainstorming; we were on a roll.\u00a0 About an hour later we made a major breakthrough.\u00a0 We were answering one of the \u201cdimensions\u201d in the problem specification which addresses the \u201cExtent\u201d of the problem and, among other questions, it asks specifically \u201cwhat is the trend?\u201d At this time, I noticed something in the data and I asked the plant process engineer to make a simple plot of the change of heat transfer loss over time and plot it on the same graph as reactor outlet temperature over time.\u00a0 Eureka!!!<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\">There are two major pitfalls I have seen that are a hindrance to good problem solving. Interestingly enough, one of those two pitfalls is not the difficulty in finding solutions. Rather the two pitfalls are poor problem definition and failing to use a disciplined, structured approach to solving the problem. \u2013 How to Implement Lean Manufacturing<\/p>\n<\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\">We found something.\u00a0 Even though there was a lot of noise in the data, we could see a major inflection point in mid-February.\u00a0 Something had changed at this time.\u00a0 This then gave us a clear picture of a \u201cdistinction\u201d and everyone knew we were on to something.\u00a0 We completed filling out the specification addressing all four dimensions of \u201cwhat, where when and extent\u201d and moved into \u201cpossible causes\u201d.\u00a0\u00a0 Now the logic was\u00a0flowing faster than we could document it and we quickly focused on the \u201cmost likely cause\u201d.\u00a0 It was now very clear that the reactor temperature drop was the key point.\u00a0 Soon enough we were able to connect the low temperature to lower than expected sulfur content in the feed.\u00a0 Since the reaction was exothermic, the lower sulfur feeds caused outlet temperatures to drop.\u00a0 We were able to confirm that this caused deposition of ammonium chloride and other salts.\u00a0 These salts were a known issue but had never been seen in these high concentrations nor had they been seen this far upstream in the reactor outlet.\u00a0 The lower outlet temperatures now allowed the salts to precipitate in the F\/E exchangers rather than further downstream.\u00a0 We determined a temporary fix was to raise the inlet temperature until the outlet temperature was above salt sublimation temperatures.\u00a0 It was now mid-afternoon and, while several of us continued the documentation, two engineers went to the plant to test our hypothesis.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-the-results\">The Results<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">First, they increased inlet temperatures and within an hour they could tell the exchanger efficiencies had risen.\u00a0\u00a0 We had confirmed the solution.\u00a0 Second, in a controlled experiment over the next days, the engineers lowered the temperature and raised it again to confirm we had developed a corrective action.\u00a0 Third, and finally, we raised the reactor outlet temperature substantially to \u201cheat soak\u201d the exchangers to see if we could improve the exchanger efficiencies; it worked and we got back some of the losses as some salts sublimed.\u00a0 After more analysis we reported that we had found the problem and with the cost of a little energy, we could run the plant to the next scheduled shutdown.\u00a0 The problem solving and decision making was a success.\u00a0 The next week the team reviewed the project, began working on the follow-up items and went through a formal Potential Problem Analysis.\u00a0 The application of the systematic problem solving technique to this problem was a huge success, saving a million-dollar emergency shutdown and untold millions in lost profit opportunities.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have read either of my books, How to Implement Lean Manufacturing or Lean Refining \u2013 How to Improve Performance in the Oil Industry, you will note a very important statement I make.\u00a0 This statement, surprisingly, IS NOT widely shared among the majority, but is clearly understood by experts and it becomes a painful reality to those who choose to ignore it.<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\">There are two major pitfalls I have seen that are a hindrance to good problem solving. Interestingly enough, one of those two pitfalls is not the difficulty in finding solutions. Rather the two pitfalls are poor problem definition and failing to use a disciplined, structured approach to solving the problem.<\/p>\n<\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\">The Kepner-Tregoe (KT) methodology is the very best I have ever seen to attack these two problems.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-problem-definition\">Problem Definition<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">First the problem statement is not just a statement, but it is further specified by what KT calls the four dimensions that \u201cbox in the problem.\u201d\u00a0 Those four dimensions are:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>What is the problem?<\/li>\n\n\n\n<li>Where is the problem?<\/li>\n\n\n\n<li>When is the problem? And<\/li>\n\n\n\n<li>What is the extent of the problem?<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">As powerful as this is to get an understanding of the situation, there is yet another aspect of the specification.\u00a0 When you begin to specify each problem, asking \u201cwhat, where, when and the extent\u201d of the problem, the KT methodology includes the \u201cis not\u201d portion, and this is pure genius.\u00a0 For example, if you have a problem that has to do with defects of a certain nature, you likely have a small population of defects to use as you define these four dimensions.\u00a0 However, as soon as you include the \u201cis not\u201d analysis the size of your database just increased dramatically.\u00a0 For example, lets say you are having problems in a milling operation and there are five mills operating in parallel.\u00a0 You ask where are you making the defect?\u00a0 Then someone does some analysis and you find that you are only making them on Mill D.\u00a0 Then you ask the \u201cis not\u201d question which is, Where could we be making bad parts, but are not?\u00a0 And the answer is now Mill A, Mill B, Mill C and Mill E.\u00a0 Which leads to the next KT question which asks you to describe the differences and distinctions.\u00a0 Now all five mills become a source of problem solving data \u2026 and voila you have significantly improved your chances of finding the root cause.\u00a0 Although KT says they improve the problem specification with the four dimensions, once you consider the \u201cis not\u201d option for each dimension, I say they have 8 dimensions that lead to problem specification.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">People have told me numerous times that a problem well-defined is 50% solved.\u00a0 Rather I find that a problem well-defined is more likely 90% solved, and I have seen no process to define problems that even approaches the KT methodology.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-structured-approach\">Structured Approach<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Typical problem solving is too often \u201cready-fire and then aim.\u201d\u00a0\u00a0 Or said another way, one CEO, after seeing us solve a knotty problem that had bugged one of his refineries for years asked me, \u201cWhy is it we seem to have the time and resources to do it again and again, but not the time to do it right the first time?\u201d\u00a0 I do not have simple answers to those issues but what I find is the answer lies somewhere enmeshed in the topics of focus, discipline and maturity.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This I know for sure.\u00a0 Your chances of making good decisions, finding true root causes and avoiding future problems lie squarely in the domain of people with intimate process knowledge using a structured approach.\u00a0 Again, the KT methodology is superior to any other method I have used.\u00a0 Starting with a clear problem specification and using logical analysis to find the root cause is only the beginning.\u00a0 Almost always, even if there is only one problem found, there are often many ways to solve it.\u00a0 This requires Decision Analysis, (DA) another KT staple.\u00a0 Finally, all decisions have risks and there are possible future problems, which the KT methodology addresses with Potential Problem Analysis (PPA).\u00a0\u00a0 In the case just studied, if KT PPA had been used prior to this run, very likely the situation they faced would have never occurred.\u00a0 As we moved the team into PPA as part of the solution, we discussed this.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">I asked the team, \u201cWhy did we not evaluate this on the changes that were made seven months earlier?\u201d\u00a0 The answers were not very impressive and mostly they were somewhere between excited that we had solved this problem and embarrassed that it took seven months to realize they were trying to fix the wrong problem\u2014especially since with the same team and the same data we wrapped this up in less than one day.\u00a0 However, now there was a new energy in that they had seen how the KT methodology could assist them in their day-to-day activities.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A few weeks later the LS program manager led them through another KT problem solving session.\u00a0 Again they solved it in one session; a seemingly unsolvable problem that had plagued them for months.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-what-about-lean-manufacturing\">What about Lean Manufacturing?<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Lean manufacturing is \u2013 The creation of a culture of continuous improvement and respect for people.\u00a0 And the \u201cMeans to Lean\u201d is \u2014<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Problem-solve your way to the Ideal State;<\/li>\n\n\n\n<li>Through the total elimination of waste;<\/li>\n\n\n\n<li>Using a fully-engaged workforce.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">You will note it all starts with problem solving.\u00a0 Literally the vitality and the success of any lean transformation is dependent upon the ability to define and solve problems.\u00a0 While the KT technique is one of my favorites, I use other problem-solving techniques including the Six Questions of Continuous Improvement (see www.qc-ep.com), the statistical tools of Six Sigma, the Five Whys, the Shainin tools and others.\u00a0 However, when I have a really tough, a really large or a really consequential problem which are so common in an oil refinery,\u00a0 I count on the KT methodology to get me results \u2026 and it does; just as it did in this case.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-lean-refining-and-the-kepner-tregoe-methodology\">Lean Refining and the Kepner-Tregoe Methodology<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">I have used the KT process since the early 70s when I was first an engineer for Chevron.\u00a0 Later as a manager I taught my supervisors how to use these methods and we would send managers to the KT training so we would have someone on staff to keep the process fresh and consistently used.\u00a0 When I wrote \u201cLean Refining \u2013 How to Improve Performance in the Oil Industry\u201d (Industrial Press, 2017), which addressed the application of lean manufacturing strategies, tactics and skills in the oil industry, I determined that refineries needed to immediately create or augment six critical skill areas.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Six Initial Skill Focus Areas are:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Leadership<\/li>\n\n\n\n<li>HK planning<\/li>\n\n\n\n<li>Leader standard work<\/li>\n\n\n\n<li><strong>Problem solving<\/strong><\/li>\n\n\n\n<li>Statistical techniques<\/li>\n\n\n\n<li>Meeting management and meeting facilitation<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Later in the text, regarding problem solving I say:<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\">\u201c\u2026the KT methodology, should be taught to a broad range of employees. All engineers, managers and those assigned specifically to problem solve should have KT training. In time, a lean support team will be staffed, and all these members must be KT proficient. <strong>In addition, you should have at least one KT-certified trainer for the facility<\/strong>.\u201d<\/p>\n<\/blockquote>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-a-final-word-about-the-kt-methodology\">A Final Word About the KT Methodology<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The KT process promotes yet another gain I have seen often; yet it is seldom discussed.\u00a0 After anyone works through the process, they are almost universally impressed with both the process and the results.\u00a0\u00a0 Unfortunately, I have been in the control room on many occasions when we did not have the luxury of sitting down with a team of talented people to fill out the specification, develop possible causes and work through a problem.\u00a0 The problem was right there in our faces and we needed to act in the next few minutes or there would be serious problems.\u00a0 For those who practiced the KT process regularly, I found they were both faster and clearer thinkers in this type of a crisis.\u00a0 Following the methodology not only gives you better answers but it also trains you to think in a clear, logical and integrated process that assists you in any problem you might encounter anywhere.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In any Lean transformation, especially in an oil refinery, one key to success is the ability to solve problems.\u00a0 When it comes to addressing major issues of problem solving so you can find superior solutions, make better decisions and avoid future problems, I know of no system superior to the KT methodology.\u00a0\u00a0 In a refinery, with a never-ending supply of large, complex and consequential problems, the KT skills should be widely used and supported.\u00a0 That will make a significant difference as you try to apply the lean strategies, tactics and skills and work to make your facility a world-class performer.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Lonnie Wilson<\/strong> is the author of How to Implement Lean Manufacturing (McGraw Hill 2009, 2015) which was recently translated into Chinese by Beijing University and McGraw Hill. He is also the author of Lean Refining: How to Improve Performance in the Oil Industry (Industrial Press, Inc. 2017). Founder of Quality Consultants in El Paso, TX, Lonnie was in refinery management at Chevron for 20 years. In addition to his expertise in evaluation, design of change and training in Lean Manufacturing, Lonnie is an expert problem solver, Six Sigma Master Blackbelt and trainer.\u00a0 In his not-so-spare time Lonnie is an avid reader and soccer fan.\u00a0 If you are looking for good books on lean or its related fields, check out \u201cLonnie\u2019s library\u201d on his website, <a href=\"https:\/\/www.qc-ep.com\/\" target=\"_blank\" rel=\"noopener\">www.qc-ep.com<\/a>.\u00a0 He not only has an extensive library but each book is critiqued.\u00a0 Alternatively, if you wish to discuss those topics\u2026or soccer\u2026just give him a call.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\" id=\"h-about-kt\">About KT<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Kepner-Tregoe<\/strong> has empowered thousands of companies to solve millions of problems. KT provides a datadriven, consistent, scalable approach to clients in Operations, Manufacturing, IT Service Management, Technical Support and Learning and Development. We empower you to solve problems. KT provides a unique combination of skills development and consulting services, designed specifically to reveal the root cause of problems and permanently address organizational challenges. Our approach to problem solving will deliver measurable results to any company looking to improve quality and effectiveness while reducing overall costs<\/p>\n","protected":false},"excerpt":{"rendered":"<p>And saves millions Lonnie Wilson, author of the Lean classic, How to Implement Lean Manufacturing, offers a case study of real-life, problem solving that saved millions of dollars, and then a deeper dive into troubleshooting methods. While the case study is specific to a Lean, refining situation, both the case study and overview of root [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":35377,"template":"","white-paper-type":[],"class_list":["post-35376","white-paper","type-white-paper","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.7 (Yoast SEO v27.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Oil Refinery Avoids Shut Down Through Structured Root Cause Analysis - Kepner-Tregoe<\/title>\n<meta name=\"description\" content=\"So you can find superior solutions, make better decisions and avoid future problems, I know of no system superior to the KT methodology.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kepner-tregoe.com\/zh-hans\/resources\/whitepapers\/oil-refinery-avoids-shut-down-through-structured-root-cause-analysis\/\" \/>\n<meta property=\"og:locale\" content=\"zh_CN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Oil Refinery Avoids Shut Down Through Structured Root Cause Analysis\" \/>\n<meta property=\"og:description\" content=\"So you can find superior solutions, make better decisions and avoid future problems, I know of no system superior to the KT methodology.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/kepner-tregoe.com\/zh-hans\/resources\/whitepapers\/oil-refinery-avoids-shut-down-through-structured-root-cause-analysis\/\" \/>\n<meta property=\"og:site_name\" content=\"Kepner-Tregoe\" \/>\n<meta property=\"article:modified_time\" content=\"2026-01-13T15:44:28+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/kepner-tregoe.com\/wp-content\/uploads\/2025\/07\/41-e1692354636424-6.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"800\" \/>\n\t<meta property=\"og:image:height\" content=\"534\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"14 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/kepner-tregoe.com\\\/zh-hans\\\/resources\\\/whitepapers\\\/oil-refinery-avoids-shut-down-through-structured-root-cause-analysis\\\/\",\"url\":\"https:\\\/\\\/kepner-tregoe.com\\\/zh-hans\\\/resources\\\/whitepapers\\\/oil-refinery-avoids-shut-down-through-structured-root-cause-analysis\\\/\",\"name\":\"Oil Refinery Avoids Shut Down Through Structured Root Cause Analysis - 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