The study by Burden et al. explores the prevalence and impact of administrative harm (AH) in healthcare, defined as the adverse consequences of administrative decisions that affect work structure, processes, and programs. The research, conducted through a mixed-methods approach including a survey and focus groups, involved 41 participants from 32 organizations. Key findings include: 1. **Pervasiveness and Impact**: AH is perceived as widespread, affecting patients, the workforce, and organizations. It is seen as a root cause of clinical harm and moral injury among healthcare professionals. 2. **Challenges in Identification and Measurement**: Participants noted that AH is challenging to measure and lacks clear mechanisms for identification and feedback. This is due to decisional distancing, power dynamics, and a lack of psychological safety. 3. **Organizational Pressures**: Organizational pressures, such as the need to act quickly and the lack of long-term planning, contribute to recurring AHs. Communication silos and a lack of collaboration between administrators and clinicians exacerbate these issues. 4. **Solutions**: Many solutions were proposed, including improved communication, collaboration, and shared understanding between decision-makers and those affected by decisions. Third-party consultants were identified as a specific source of AH, and their influence was perceived as both beneficial and harmful. The study highlights the need for organizations to develop robust processes to identify, measure, and address AH, emphasizing the importance of a holistic approach that considers financial sustainability, workforce health, and patient needs.The study by Burden et al. explores the prevalence and impact of administrative harm (AH) in healthcare, defined as the adverse consequences of administrative decisions that affect work structure, processes, and programs. The research, conducted through a mixed-methods approach including a survey and focus groups, involved 41 participants from 32 organizations. Key findings include: 1. **Pervasiveness and Impact**: AH is perceived as widespread, affecting patients, the workforce, and organizations. It is seen as a root cause of clinical harm and moral injury among healthcare professionals. 2. **Challenges in Identification and Measurement**: Participants noted that AH is challenging to measure and lacks clear mechanisms for identification and feedback. This is due to decisional distancing, power dynamics, and a lack of psychological safety. 3. **Organizational Pressures**: Organizational pressures, such as the need to act quickly and the lack of long-term planning, contribute to recurring AHs. Communication silos and a lack of collaboration between administrators and clinicians exacerbate these issues. 4. **Solutions**: Many solutions were proposed, including improved communication, collaboration, and shared understanding between decision-makers and those affected by decisions. Third-party consultants were identified as a specific source of AH, and their influence was perceived as both beneficial and harmful. The study highlights the need for organizations to develop robust processes to identify, measure, and address AH, emphasizing the importance of a holistic approach that considers financial sustainability, workforce health, and patient needs.