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Review
. 2025 Sep;109(5):1129-1144.
doi: 10.1016/j.mcna.2025.03.003. Epub 2025 May 8.

Administrative Harm

Marisha Burden  1 , Gopi Astik  2 , Amy Lynn Teleron  3 , Alpesh N Amin  4
Affiliations
Review

Administrative Harm

Marisha Burden et al. Med Clin North Am. 2025 Sep.

Abstract

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.

Keywords: Administrative harm; Organizational decision-making; Workforce.

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Conflict of interest statement

Disclosure Dr M. Burden reports funding from the Agency for Healthcare Research and Quality, United States, the American Medical Association, United States, the National Institute for Occupational Safety and Health, United States, and the University of Colorado Innovations digiSPARK award that is not related to this work. Dr M. Burden contributed to developing GrittyWork, a digital workforce application and a trademark of the University of Colorado. Dr G. Astik reports funding from the Agency of Healthcare Research and Quality, which is unrelated to this work. Dr A.L. Teleron has no disclosures to report. Dr A.N. Amin reports serving as a speaker and/or consultant for Pfizer, Salix, Alexion, AstraZeneca, Bayer, Ferring, Seres, Spero, Eli Lilly, Nova Nordisk, Gilead, Renibus, GSK, Dexcom, Reprieve, HeartRite, Aseptiscope, unrelated to this study.

MeSH terms