Administrative Harm - 01/08/25

Doi : 10.1016/j.mcna.2025.03.003

Marisha Burden, MD, MBA ^a,^⁎ , Gopi Astik, MD, MS ^b, Amy Lynn Teleron, MD, MBA ^c, Alpesh N. Amin, MD, MBA ^d
^a Division of Hospital Medicine, Department of Medicine, University of Colorado School of Medicine, 12401 E. 17th Avenue, Aurora, CO 80045, USA
^b Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, 211 East Ontario, Suite 700, Chicago, IL 60611, USA
^c Division of Hospital Medicine, Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, TT4-404, Cleveland, OH 44195, USA
^d Division of Hospital Medicine and Palliative Medicine, University of California, 333 City Boulevard West, Suite 500, Orange, CA 92868, USA

^∗Corresponding author.

Résumé

Administrative harm (AH) refers to the adverse consequences of administrative decisions in health care and directly influences patient care, workforce, and organizational outcomes. It is pervasive and comes from all organizational decision-makers, including formal and informal leaders. Organizations often lack mechanisms for identification, measurement, and feedback related to AH. Proposed solutions include developing a definition and understanding of AH, collaborative cultures and psychological safety, structures and processes to support optimal decision-making, measurement and data strategies for AH, and reporting and learning systems. These approaches aim to mitigate administrative harm and improve health care delivery and outcomes.

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Keywords : Administrative harm, Organizational decision-making, Workforce