The Other Last-Mile Problem

"For organizations operating in harsh, mission-critical environments, there is another last-mile problem that is less obvious, but that can be even more consequential. Where the traditional last-mile problem is about getting an object all the way to its end user, this other last-mile problem is about moving knowledge from abstract theory to messy reality. When organizations fail to cross this last mile under pressure, their teams are ineffective at best and misguided or dangerous at worst."

"As an example, consider an emergency department team responding to a patient with a potential stroke. The clinical theory around acute stroke treatment is relatively straightforward-stabilize the patient, figure out the course of what happened, and see if they are a candidate for acute therapies. In practice, this means bringing doctors, nurses, pharmacists, and imaging technicians that typically work in three (or more) separate departments together to work as a team at any point, day or night, often with zero notice."

Logistics last-mile refers to the final route to deliver a good or service to an end user and is often convoluted and rugged, resisting efficiencies of scale and protocol. Organizations in harsh, mission-critical environments face a different last-mile: translating abstract knowledge into messy reality under pressure. Failure to bridge this gap renders teams ineffective, misguided, or dangerous. Acute clinical responses, such as emergency stroke care, require rapid assembly of multidisciplinary personnel who must integrate partial views into a usable mental model in real time. Success depends on shared mental models, individual observation and reflection, and lower communication and coordination costs.

Read at Psychology Today