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Operational friction: Why you should care, and what to do about it

As human beings, we’ve come to expect frictionless experiences in our everyday lives. With the click of a button or a tap on the screen, we can score a last-minute reservation, add ourselves to a waitlist, and get products, meals, and more delivered right to our doorstep—while we're sent real-time updates via text or email until they’re in our hands. 

More traditional consumer industries, from retail to hospitality, opened our eyes. They taught us to expect these kinds of friction-free, end-to-end experiences. Naturally, we bring these expectations to healthcare too. Why wouldn’t we want the same seamless journey when our health is concerned? 

Healthcare organizations are still struggling to live up to patients’ expectations for a high-quality experience at every moment, beyond the traditional clinical interaction. Access and easy navigation across the journey of health and care remains a challenge—one that’s far from seamless. In fact, new research from Press Ganey’s enterprise analytics and data science team shows at least 50% of patients encounter operational friction at some point during their many different interactions. Not only is this friction quantifiable, but its impact at distinct points along the care journey can also erode confidence, trust, and ultimately our ability to achieve important performance outcomes.  

First: What is “operational friction”? In healthcare, operational friction refers to gaps between people, process, and technology that create challenges across the journey of health and care. This might look like long wait times, with little to no communication about delays. It might be appointment scheduling issues or feeling like a provider doesn’t understand your medical history and current needs. Or difficulties getting questions answered online or over the phone.  

Accessing care shouldn't require more work, especially when a patient may already feel vulnerable and stressed out about the situation. These types of experiences are driving many patients to seek out alternative providers and organizations for their care. 

Why should healthcare organizations care about operational friction across the journey of health and care? 

When patients encounter just one instance of friction, their likelihood of not recommending that provider’s office or organization nearly doubles.  

Conversely, when patients experience less friction with an organization, they’re more loyal to it. One way of thinking about patient loyalty is that it’s really a measure of trust—i.e., patients’ confidence in an organization’s consistent ability to partner with them in the delivery of safe, high-quality, compassionate care. Creating this type of partnership not only drives meaningful clinical outcomes, but it also allows organizations to retain and expand their relationships with patients, driving growth. 

But operational friction isn’t a one-size-fits-all experience. Its impact on people can be different based on demographics, such as age/generation, gender identity, race/ethnicity, location, and more. Its impact can also be different based on the specific specialty practice—for example, patients with cardiac care needs, people who are pregnant, or those who need orthopedic care. They have different needs and different paths to care. Early studies by Press Ganey indicate that the threshold for operational friction is important to understand at both an aggregate and individual level. 

This underscores the critical importance of gathering feedback, demographics, and segmenting the data to better engage and understand specific populations—as well as their experiences and needs at critical moments —and co-create a better experience for all.  

Outside of patient confidence and affinity, the impact of operational friction is far reaching across an organization. Data shows even top-performing providers—who are excellent communicators and coordinate with others on the care team—can’t fully overcome the negative effects of friction. Operating in an environment where poor processes and unnecessary barriers get in the way of doing the work can have significant implications on the employee experience, patient and workforce safety, and overall perception of your brand.  

In many cases, clinical and operations teams develop work-arounds, shoulder unnecessary responsibilities, and carry the burden to overcome inefficiency. Over time, near misses and incremental friction can erode workforce trust, lead to harm, and, ultimately, impact employee retention.  

The good news: Operational friction is detectable and fixable. Setting ourselves, our teams, and the communities we serve up for success might sound daunting, but it’s well within our reach.  

Identifying, and overcoming, operational barriers to healthcare 

Healthcare leaders must identify friction that spans across the journey. Then, they must begin to prioritize investments and improvements among impacted stakeholders. By leveraging quantitative and qualitative data from patients and their families, along with physicians, nurses, and our broader workforce, we can detect the areas of greatest impact first.  

In our latest e-book, “The hidden costs of operational friction,” we explore the six data-backed strategies that can help. 

  1. Rethink access and how you handle wait times. Many patients cite wait time as a primary driver of operational friction. Limited communication around delays or availability just makes a bad situation worse. Organizations can lean on digital technologies to engage with patients before, during, and after care to keep them informed about delays and share reminders about future appointments.  
  2. Expand how and where you engage patients. Open more channels of communication, and let patients engage on their terms. For example, some may favor online portals over calling an office, and automated text messages over being called with appointment reminders. Consider interactive stations, signage, and other sensory supports (art, music, etc.) to complement staff interactions.  
  3. Elevate the voice of and partnership with the patient. If you don’t have one already, institute a family advisory council to partner on meaningful ways to improve. Regularly gathering feedback about their experiences and working with them on the solutions gives you concrete and credible information on what needs fixing (and what’s going great).  
  4. Leverage integrated data to drive improvements. Pinpoint and prioritize process improvement opportunities by looking across data to see how many stakeholders have similar issues. For example, are physicians and patients both saying it’s difficult to access a specific service? Similarly, how is friction impacting other outcomes, such as serious safety events and preventable harm?  
  5. Reimagine how care teams are designed and deployed. Using data to better organize care teams around moments that matter ensures you’re best matching professionals with patients’ needs. Can you offer telehealth visits? Can patients be seen by a nurse practitioner or a clinical social worker to address issues before the attending physician arrives? Or can care team members verify information with the patient in person, instead of the patient verifying data online, then once again via paper forms in the office?  
  6. Be deliberate about culture and how each individual contributes to it. Overcoming instances of operational friction is an all-hands effort. Fundamentally, healthcare is anchored in making the impossible possible. It’s filled with people who show up every day to do their best to help others. From security to chaplains, lab technicians to nurse navigators, surgeons to billing, helping employees connect the dots between their role and the organization’s mission—while equipping them with tools to improve—drives engagement and performance outcomes. 

To learn more about how operational friction impacts the Human Experience, download our e-book. If you're looking to understand your performance and drive improvement, the experts at our Centers for Excellence and consulting are ready to talk. Email us at: 

About the author

Press Ganey, a leading healthcare performance improvement solutions company, offers an integrated suite of solutions that put Human Experience at the center of healthcare enterprise transformation. Delivered through a cutting-edge digital platform built on a foundation of data security, Press Ganey solutions address patient experience, healthcare consumer experience, workforce engagement, safety, clinical excellence and more. Guided by its team of renowned healthcare thought leaders, Press Ganey works with more than 41,000 healthcare facilities to reduce patient suffering, enhance caregiver resilience and improve the overall safety, quality and experience of care. Press Ganey is a PG Forsta company.

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