Administrative Harm and Workforce Strain Indicators - 09/09/26

Doi : 10.1016/j.ccc.2026.07.009

Kara-Grace Leventhal, MD ^a,^⁎ , Darren Caudill, DO ^b, Marc Moss, MD ^c, Mustafa Ozkaynak, PhD ^d, Marisha Burden, MD, MBA ^e

^a Division of Hospital Medicine, Department of Medicine, Johns Hopkins University, 600 North Wolfe Street, Meyer 8-134B, Baltimore, MD 21287, USA

^b Division of General Internal Medicine and Geriatrics, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

^c Division of Pulmonary, Allergy, and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO, USA

^d College of Nursing, University of Colorado Anschutz, Aurora, CO, USA

^e Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA

^∗ Corresponding author.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 09 September 2026

Resumen

The way work is structured within health care, from work environments to workloads, shapes both the workforce experience as well as job performance. Administrative harm describes the downstream effects of upstream decisions on the design of work itself, impacting workforce well-being and performance, patient care and outcomes, and organizational outcomes. The article reviews current and emerging opportunities to harness digital signals readily available within the electronic health record (EHR), including EHR use metadata and related data sources, to measure, monitor, and predict how work design (job demands and resources) affects workforce, patient, and organizational outcomes.

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Keywords : Administrative harm, ICU workforce, Workforce strain indicators, Work design, Burnout, Staffing models, Clinical operations, Predictive analytics