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Case Studies

Case One The NASA Knowledge Map

At 11:38 a.m. on January 28, 1986, the space shuttle orbiter Challenger launched from

Cape Canaveral, Florida. Less than a second later, gray smoke streamed out from a hot

flare burning in the rocket motor. The flare ignited liquid hydrogen and nitrogen inside

the fuel tank, which exploded 73 seconds after liftoff. The Challenger was torn apart,

and all seven astronauts were killed.

In the days and weeks following the disaster, it became clear that two O-ring seals

within the rocket booster had failed. Engineers working for the space agency had

warned of just such a failure. In particular, they had expressed concerns that the O-ring

seals could fail when outside temperatures dropped below 53 degrees Fahrenheit. On

the morning of January 28, the temperature was 36 degrees. The launch pad was

covered with solid ice.

In response to the Challenger disaster, NASA established the Program and Project

Initiative whose purpose was to improve individual competency for NASA employees—

and to prevent another catastrophe. The Challenger, however, was followed by the

failure of three expensive Mars missions. The software system used for the Mars

Climate Orbiter mission erred when one part of the software used pound-force units to

Book Title: eTextbook: Fundamentals of Information Systems Chapter 7. Knowledge Management and Specialized Information Systems Case Studies



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calculate thrust, whereas another part used the newton metric unit. Less than a month

later, the Mars Polar Lander crashed into the surface of the planet at too high velocity—

triggering the failure of a concurrent mission, the Mars Deep Space 2 probes. A review

of the Deep Space 2 mission revealed that NASA engineers had decided to skip a

complete system impact test in order to meet the project’s tight deadline. In the wake of

these failures, NASA sought to improve communication and collaboration among teams.

Yet in 2003, a large piece of insulation foam broke off from the Columbia space shuttle

during launch, creating a hole in its wing, ultimately causing a catastrophic breach of the

shuttle during reentry; again, all seven astronauts on board were killed.

These terrible losses brought about a fundamental change in NASA’s approach to

knowledge management. In 1976, NASA had created the Office of the Chief Engineer

(OCE), which was initially staffed by only one employee whose job was to offer advice

and expertise on NASA’s administration. In response to the Challenger disaster, NASA

established the Academy of Project/Program and Engineering Leadership (APPEL) as a

resource for developing NASA’s technical staff. In 2004, the agency moved APPEL to

the OCE in order to promote talent development through the analysis of lessons learned

and through knowledge capture—the codification of knowledge. The purpose was to

improve not only individual but also team performance and to overcome the disconnect

between the different engineering and decision-making teams across the huge

organization. The overarching goal was to create an organization that learns from its

mistakes. APPEL emphasized not only technical training curriculum but also the sharing

of practitioner experience, storytelling, and reflective activities. In 2012, NASA furthered

this initiative and established the role of chief knowledge officer whose mission is to

capture implicit and explicit knowledge. Today, the agency has an extensive knowledge



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management system called NASA Knowledge Map, which is a tool that helps

employees navigate the enormous collection of knowledge within NASA. The map

encompasses six major categories:

Case Studies and Publications,

Face-to-Face Knowledge Services,

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