This Cause and Effect Diagrams video by Bob Lloyd, Executive Director of Performance Improvement, Institute for Healthcare Improvement, provides a practical overview of using fishbone diagrams to help quality improvement teams see the system that produces the current outcomes. In the video, Dr. Lloyd uses an example from healthcare, but education quality improvement teams should use this classic tool, too. We find that the fishbone diagram helps improvement teams identify the critical systems elements (such as people, materials, and methods) that create the system, and we can’t create meaningful improvement without seeing the system.