Article Impact Level: HIGH Data Quality: STRONG Summary of JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.1890 Dr. Marisha Burden et al.
Points
- Researchers studied administrative harm (AH) in healthcare, focusing on hospitalist clinicians’ and administrative leaders’ experiences through a mixed-methods approach that included surveys and virtual focus groups.
- Forty-one participants from 32 organizations discussed the pervasive nature of AH, emphasizing the difficulty in identifying and measuring it due to factors like lack of psychological safety and unclear decision ownership.
- Key findings include the widespread impact of AH across all leadership levels, inadequate mechanisms for AH identification and measurement, and organizational pressures contributing to AH occurrences.
- The study highlights the significant issue of AH within healthcare organizations and the absence of structured approaches to mitigate it effectively.
- The research calls for healthcare leaders to prioritize evaluating and reforming administrative practices to address and reduce the negative impacts of administrative harm on healthcare delivery.
Summary
In a qualitative study examining the concept of administrative harm (AH) within healthcare settings, researchers focused on the experiences of hospitalist clinicians and administrative leaders. The study, conducted using a mixed-methods approach that included a 12-question survey and virtual focus groups on June 13 and August 11, 2023, explored the pervasive and often overlooked issue of AH—defined as the adverse consequences of administrative decisions that affect work structure, processes, and programs. Forty-one participants from 32 different organizations engaged in discussions highlighting the widespread nature of AH and its identification and measurement challenges.
The study’s primary findings revealed three main themes: First, AH is pervasive across all levels of leadership, with participants reporting widespread adverse impacts stemming from various sources within healthcare systems. Second, there is a notable deficiency in mechanisms for the identification, measurement, and feedback of AH, attributed to factors such as lack of psychological safety, ingrained workplace cultures, and ambiguity in decision ownership. Third, organizational pressures were frequently cited as contributors to the occurrence of AH. Participants also suggested multiple potential solutions to address these challenges.
The study concluded that AH is a significant issue within healthcare organizations, affecting numerous stakeholders across various levels. Despite its prevalence, there is a profound lack of structured approaches to identify, measure, or mitigate AH effectively. These findings underscore the urgent need for healthcare organizations to implement and enhance structures and processes that could address AH, ultimately improving decision-making and reducing the negative impacts on healthcare delivery. This research serves as a call to action for healthcare leaders to prioritize evaluating and reforming administrative practices to safeguard against the detrimental effects of administrative harm.
Link to the article: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2820266
References Burden, M., Astik, G., Auerbach, A., Bowling, G., Kangelaris, K. N., Keniston, A., Kochar, A., Leykum, L. K., Linker, A. S., Sakumoto, M., Rogers, K., Schwatka, N., & Westergaard, S. (2024). Identifying and Measuring Administrative Harms Experienced by Hospitalists and Administrative Leaders. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2024.1890
