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Practical Solutions for Healthcare Management and Policy (Collection) by Carolyn Pexton Dr. Brett E. Trusko Praveen Gupta, Dr. H. James Harrington, Douglas A. Perednia M.D., Jim Champy, Harry Greenspun M.D.

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9. Friction

“It’s not the work which kills people, it’s the worry. It’s not the revolution that destroys machinery, it’s the friction.”

Henry Ward Beecher

“Friction” within the healthcare machine can be defined as the wear, tear, and loss of efficiency caused by aspects of the system that are poorly designed or operated. Friction typically isn’t the fault of any individual part of the machine, nor is it typically a clear defect imposed from the outside. Instead, elements of friction are more likely to be structural defects that keep the wheels of healthcare from turning smoothly, efficiently, and economically. Some elements of friction are relatively simple and easy to fix, but can have a disproportionately large effect on all the elements ...

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