Administrative harm (AH) may emerge from organizational decisions based on financial, regulatory, and other non-critical factors and can adversely impact patients and staff. In this study, hospitalists, leaders, researchers, and patient and family advocates were largely unaware of the term administrative harm but were familiar with these types of decisions. Three themes emerged: AH is pervasive and comes from all levels of leadership; organizations lack mechanisms to study AH; and organizational pressures are contributing factors.