Because the presenters knew their material forward and back, they experienced what social psychologists call “the curse of knowledge”—the cognitive bias that makes it difficult for them to remember what it’s like to be a beginner seeing the content for the first time. That’s why they assumed the room could quickly grasp all the salient points as they flipped from slide to slide.

But if the goal of the meeting is to make decisions or give feedback, it can be tough for stakeholders to understand the material well enough in the span of a single meeting to arrive at thoughtful conclusions.

The solution is to help everyone come prepared. The change we made to our decision and review meetings was to ask the organizers to send out any presentations or documents the day before so that everyone got the chance to process the information in advance. This meant that I could spend as much time as I needed to understand all the charts and graphs, which allowed me to be a better contributor in the meeting.

The Cancer Center suffered from two hallmarks of organizations that are plagued with coordination snafus. First, powerful people ignore, dismiss, denigrate, and even undermine people and groups they need to mesh their work with. Oncologists saw themselves as being at the top of the pecking order at the center and the work of other specialists as secondary, trivial, or downright useless. They dismissed side effects, including fatigue, diarrhea, and cramps, caused by chemotherapy that they prescribed as “normal” and left it to patients to find specialists to treat such problems. Second, powerful people devote little attention to solutions for coordination problems.

Stanford’s Chip Heath and the late Nancy Staudenmayer showed that people are prone to suffer from coordination neglect: they fixate on parts of organizations and ignore how the parts ought to work together. Chip and Nancy distinguish between two modes of coordination neglect. The first mode is component focus, where people in a team or silo devote too much attention to their own work and too little to how it will shape and be shaped by others’ work. Like the Ford Motor Company engineer who admitted his group was so fixated on designing car chassis that “when I saw a car driving down the road, all the rest [other than the chassis] disappeared.

Specialists are also prone to overconfidence, to believe their narrow knowledge makes them experts in all other areas. They overestimate their understanding of others’ work, oversimplify it, and denigrate the dedication and skill of people outside their area. Overconfidence is another reason that the technical people Deborah studied designed flawed products. They were sure their narrow technical knowledge was all that was required to design great products—and believed that talking to and listening to manufacturing people, salespeople, or customers was a waste of time.

Partition focus, the second mode of coordination neglect, happens when decision-makers devote too much attention to assembling an organization with great parts—and too little attention to how the pieces ought to work together. That’s what happened when Cancer Center leaders fixated on assembling the best specialists in the world and supporting them with excellent staff and technologies—and thought little about linking their work with that of other departments and specialists.