The Translation That Killed
Morton Thiokol's engineers said don't launch. They had the data. Cold temperatures. O-ring erosion. 53 degrees was the safety limit. The morning of January 28, 1986, it was 36 degrees.
The engineers were right. The shuttle exploded anyway.
Here's what the Rogers Commission found: the warning never reached the people making the decision. Not in full. Not with context. Reports got summarized. Nuance got compressed. Risk got translated into bureaucratic language that no longer sounded alarming.
The fatal phrase wasn't a lie. It was a handoff.
"Acceptable risk" appeared in the final briefing. Nobody asked acceptable to whom. The engineers who understood O-ring behavior weren't in the room. The managers who were in the room didn't understand O-ring behavior.
Same organization. Same information. Different translations at every boundary.
Seven people died because a warning didn't survive the distance between the people who knew and the people who decided.
The handoff was the failure. Identify The Handoff Moment in your next meeting. That's where the translation happens.
Every boundary is a translation. Every translation loses something. The Information Flow shows where to check the fidelity.