It's common to talk about clinical and operational goals as fundamentally aligned, both ultimately serving patient outcomes, and at a high enough level of abstraction that's true. It's much less true at the level where actual decisions get made, where a specific scheduling policy, staffing ratio, or throughput target can genuinely serve one priority at the direct expense of the other.
A scheduling system optimized to maximize utilization of an expensive piece of equipment is doing its job from an operational standpoint. The same system, from a clinical standpoint, may be compressing the time available for the judgment calls that don't fit neatly into a scheduled slot. Neither perspective is wrong. They're optimizing for genuinely different things, and pretending the conflict doesn't exist doesn't resolve it, it just pushes the resolution down to whoever is on the floor when the tension actually surfaces.
The healthcare organizations that handle this well don't try to eliminate the tension. They make it an explicit, named tradeoff that gets decided deliberately, at the leadership level, rather than an implicit one that gets decided ad hoc by whoever is closest to the problem at two in the morning. That means clinical leadership needs real visibility into the operational targets being set, and operational leadership needs a genuine seat in conversations about clinical workflow, rather than each group optimizing in its own lane and discovering the conflict downstream.
This is ultimately a governance question disguised as an operational one. The fix isn't a better algorithm. It's a structure where both priorities are represented in the same room, early enough that the tradeoff gets made on purpose.