Along with increased complexities in work and life in general in the twenty-first century come new and dangerous risks to workers, customers, and the general public. Drawing on decades of experience as a researcher and consultant for a range of organizations and individuals in high-risk domains, the author of this book presents a powerful theory of open communication and teamwork. This unites a range of communication practices and principles that have proven to combat risk and complexity in organizations.

The book initially focuses on NASA, an organization that experiences and engages with high complexity and risk daily. As a participant-observer in the Apollo program, the author witnessed pioneering communication practices that, for example, empowered engineers with automatic responsibility for any technical problem they perceived. It was partly the failure to follow such protocols that resulted in the catastrophes experienced in the Challenger and Columbia tragedies, as the author shows.

Using the lessons learned from the space program, the book then explores complexity and risk in medicine, aviation, the fighting of forest fires, and homelessness, again consistently finding communication practices that worked and did not work. Based on detailed research conducted over several decades, the book presents a unified theory linked to generally applicable communication practices. Case studies include the results of an international experiment of surgery conducted in ten countries that produced a highly significant reduction of deaths and infections in Africa, India, and other parts of the world, to the creation of innovative communication practices that significantly reduced risks in the US aviation industry.