Becoming the Friction Fixer

The Invisible Burden on the Frontline Clinical burnout often stems from "addition sickness"—the reflexive urge to solve problems by adding new tasks or meetings. As discussed in our Culture Coalition, Robert Sutton and Huggy Rao’s The Friction Project challenges physician, nurse, and APP leaders to act as "trustees of others’ time." We must become the "Editors in Chief" of our organizations, relentlessly removing obstacles that exhaust our frontline teams.The "GROSS" Movement and the Power of Subtraction To fight "addition bias," leaders must adopt a subtraction mindset. The "Getting Rid of Stupid Stuff" (GROSS) initiative empowers clinicians to nominate poorly designed or unnecessary tasks for elimination. At Hawaii Pacific Health, this mindset led to two distinct wins: they streamlined "stupid stuff" by turning a three-click diaper change entry into a single-click fix, and they removed "sludge" by eliminating a redundant "rounding row" click, saving 1,700 nursing hours per month."Stupid is in the eye of the beholder. Everything that we might now call stupid was thought to be a good idea at some point." — Melinda Ashton, M.D.When Friction is a Virtue—The "Slow Down to Go Fast" Principle Slowing Down to Ensure Safety Not all friction is bad. While routine workflows should be frictionless, high-stakes clinical decisions—such as surgical pauses or medication titration—require deliberate "rough edges." We must "sharpen the axe" by slowing down creative or irreversible processes. This intentional friction ensures that patient safety is never sacrificed for the sake of mere urgency.From "HIPPOs" to "Elephants"—The New Leadership Communication To eliminate "Meetingeddon" and "Email Jail," leaders must refine how they speak and listen:Move from "HIPPO" to "Elephant": Trade the "Highest Paid Person’s Opinion" (big mouth, small ears) for the "Elephant" (big ears, small mouth). Elephants solicit input from quiet voices and ask thoughtful questions even when they already have the answers.Flush "Jargon Monoxide": Use "translated letters" to clear the air—for example, replacing "peripheral edema" with "ankle swelling."Practice Smart Brevity: Use "Bottom Line Up Front" (BLUF) and the WAIT principle (Why Am I Talking?) to prevent unnecessary "pile-on" after a decision is reached.5. Conclusion: Mowing the Lawn of Friction Fixing friction is a never-ending task, similar to mowing a lawn; it requires constant vigilance to keep the "stupid stuff" from regrowing.What is one "stupid thing" you can subtract from your team's workflow tomorrow? Hosted on Acast. See acast.com/privacy for more information.