In the world of logistics, the last mile problem describes the final part of the route to deliver a good or service to the end user. Crossing that last mile is challenging. Frequently, it’s convoluted and rugged (both figuratively and literally), and the efficiencies of scale and protocols that got you to the last mile won’t get you across it.

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.

Crossing this other last mile means getting multidisciplinary and multiprofessional teams to integrate their individual, partial views of reality into a usable mental model at the point of impact during an active crisis. To put it mildly, this can be a substantial challenge.

Thankfully, it’s also a trainable skill that can improve with conscious effort. Let’s look at strategies that........

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