When Good Intentions Create Hidden Drag

The waste created by Leadership Friction

A senior executive team, I was advising, at a regional health system was rolling out a new patient access initiative intended to improve scheduling speed and reduce wait times. The strategy was solid, the metrics were clear, and every leader believed in the goal. Yet six weeks into execution, progress had stalled.

Here’s what was happening beneath the surface:

• The COO had been telling operational leaders to “move fast and remove barriers,” pushing teams to try new workflows quickly.

• The CIO, wanting to ensure system stability, instructed his teams to “slow down and protect reliability,” leading to more cautious decision-making.

• The Chief Experience Officer, focused on patient satisfaction, encouraged managers to “prioritize the patient conversation over cycle time,” shifting the emphasis again.

Individually, each leader was making reasonable requests. Collectively, their messages created competing interpretations of what success looked like. Managers hesitated. Directors escalated small issues for clarification. Teams started building different versions of the process based on which executive they felt accountable to.

No one was wrong—yet the system wasn’t moving.

Once the leadership team recognized the friction, they came together to align on a simple, shared intent:
“Improve scheduling speed by 20% without compromising system uptime or patient experience.”

They defined decision rights, clarified constraints, and created a weekly alignment rhythm. Within weeks, execution accelerated. Teams became more confident. And the initiative gained momentum that had been missing from day one.

This example shows how leadership friction isn’t about bad leadership—it’s about uncoordinated leadership. Even strong leaders create waste when their signals don’t align. The moment they tightened the system, drag disappeared and performance improved.