In most life-science companies quality is where the calendar slows down. Not through any fault of the people: a lean team absorbing investigations, change controls, audits, reviews and release will always be the constraint, and everyone downstream learns to plan around it. That is normally accepted as the cost of being regulated.
Much of it is not. Mapping the release path end to end usually shows batches waiting on documentation review, on open deviations, or on a single qualified person as the point of decision — not on analysis. Those are process constraints, and process constraints can be removed without weakening a single control.
Deviation load is the other operational tax. Every investigation consumes production and engineering time as well as QA time, and a recurring event consumes it repeatedly. A backlog is an arithmetic problem before it is a discipline problem: events arrive faster than they close, and once the queue exists every hour spent on it is an hour not spent on the intake feeding it.
Then there is what you do not control directly. A contract manufacturer's deviation becomes your supply problem, and their inspection outcome becomes your customer's question. Supplier and CMO qualification is an operational resilience matter as much as a compliance one.