The Pre-Mortem: will your program be reviewed in 18 months?
4 MINUTES
When digital transformation stalls, we blame the technology, the vendor, the project team or the budget. The real brake is usually transformation friction: the tension between a temporary project and the permanent organisation it is trying to change. High friction is not inevitable, and it is not someone else's job. The leaders who name it early and work to reduce it are the ones who set the pace.
I recently came across the concept of transformation friction in a paper by Natalie Smith and Andrew Burton-Jones, Improving Digital Transformation Outcomes and Pace: The Role of the Board and C-Suite in Reducing Transformation Friction. Their research explored why some digital transformations succeed while others struggle, despite similar technologies, budgets and methodologies.
The authors define transformation friction as the inherent forces that arise between a temporary transformation initiative and the permanent organisation it seeks to change. Rather than treating delay as inevitable, they argue that many of the obstacles slowing change are created by tensions within the organisation itself, and can be actively reduced by leaders.
The concept resonated strongly with me because it names something I have observed repeatedly while leading large healthcare organisations. When digital transformation stalls, we reach for the obvious culprits: the technology, the vendor, the project team, the funding model. Yet in my experience the greatest source of delay is rarely technical. It is friction created by competing priorities, conflicting incentives, entrenched ways of working, and uncertainty about what the future should look like.
Healthcare is particularly exposed to transformation friction, because driving change here is like upgrading an aircraft while keeping it safely in the air. Unlike many industries, we cannot stop operations while we redesign processes, replace systems or build new capabilities. Every day, clinicians must keep caring for patients while adapting to new technologies and new ways of working. The change competes directly with the day job, and the day job never pauses.
Leadership misalignment. Transformations move fastest when executives engage in robust debate behind closed doors and emerge united behind the chosen direction. They slow dramatically when leaders support the initiative in public while quietly protecting their own domains in private. Staff detect these inconsistencies almost immediately, and respond by waiting to see which leader ultimately prevails.
Local optimisation versus organisational benefit. Every department can explain why its circumstances are unique. Sometimes they genuinely are. More often, those differences become reasons to preserve existing practice, and the cumulative effect is customisation, complexity and rising cost. Leaders have to keep balancing legitimate local needs against the broader benefit of standardisation, and keep making that trade-off out loud.
Flying the plane while fixing it. Healthcare organisations already operate at or near capacity. The same people responsible for delivering care are often expected to lead and support the change. When leaders underestimate this reality, transformation becomes an additional burden rather than a strategic priority, and quietly loses to the work that cannot wait.
A few years ago I watched these forces converge on a single finance transformation. On paper, everyone agreed. The board wanted two things: cost efficiency and reduced risk. Beneath the surface, the picture was very different.
The ICT executive and the finance executive were quietly fighting for control of the project. And the finance staff, hearing the word "efficiency", heard something else entirely: redundancies. The technology was never the problem. The board's goal, the executives' rivalry and the staff's fear were, in effect, three different transformations wearing one project name. Until those were named and reconciled, the initiative was never going to move at the pace the board expected, and it didn't.
What makes the example instructive is that the governance was not missing. There was a board, a chief executive and a properly constituted steering committee, the very structures meant to guarantee success. On paper, the project was well governed. In practice, the governance behaved as a reporting forum rather than a decision-making one, and that is where it failed. Status came up green while the rivalry beneath it stayed red. The steering committee treated the contest between the two executives as a personality clash to be managed politely, not as the governance failure it actually was. No single executive owned the outcome; the committee owned it collectively, which is another way of saying no one did, so when someone needed to spend political capital to settle the rivalry, nobody held the mandate to do it. And the board monitored what was easy to measure, cost and risk, while the thing actually slowing the program, the missing alignment at the top, never appeared on a risk register. The structure was sound. The behaviour inside it was not.
This is the trap Smith and Burton-Jones point to: a board and C-suite can assemble every governance body the textbook requires and still fail to reduce friction, because reducing friction is an active leadership behaviour, not a standing committee. Good governance does not run on the existence of the forum. It runs on what the people in the room are willing to confront.
It is also exactly what they describe as diverse accounts of the transformation's purpose. When you ask three senior people why the change matters and get three different answers, you are not looking at a delivery problem. You are looking at friction that no amount of project management will resolve, because its source is above the project, not inside it.
Perhaps the most important insight from this research is that friction is not merely resistance to be overcome. It is a natural consequence of transformation itself: the predictable grinding of a temporary initiative against a permanent organisation. The question is not whether friction exists. It always does. The question is whether leaders recognise it early and actively work to reduce it, or mistake it for someone's bad attitude and try to push harder.
In my experience, successful transformations share a common characteristic: leaders work the organisation as hard as they work the plan. They put as much energy into aligning people, settling rivalries and reassuring staff as they do into tracking scope, budget and milestones, because the plan rarely fails on its own mechanics. It fails on the human friction around it. They build alignment before they ask for momentum. They surface and resolve competing agendas rather than hoping they fade. And they keep reinforcing why the change matters, again and again, long after they personally are tired of saying it.
The organisations that transform most successfully are not necessarily those with the best technology or the largest budgets. They are the ones whose leaders understand the forces creating friction and are prepared to address them directly, starting with their own table.
Reference: Smith, N. & Burton-Jones, A. (2026). Improving Digital Transformation Outcomes and Pace: The Role of the Board and C-Suite in Reducing Transformation Friction. Information Systems Journal. doi.org/10.1111/isj.70028
If a transformation in your organisation is moving slower than the technology or the budget can explain, the friction is usually worth a conversation before it becomes a review.
Book a callAn occasional brief, no more than once a month, for senior leaders in health, government and defence: field-tested frameworks, the thinking behind my client work, and first access to new tools and dispatches. No selling, no noise.