Background: Task shifting and task sharing in healthcare are rapidly becoming more common as the shortage of physicians increases. However, previous research has not examined the changing roles of hospital administrative staff. This study clarified: (1) adverse incidents caused by hospital administrative staff and the direct and indirect impact of these incidents on patient care, and (2) which incidents directly involved hospital administrative staff. Methods: This study used secondary analysis

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... of case report data from the Japan Council for Quality Healthcare collected from April 1, 2010, to March 31, 2019, which consisted of quantitative and text data from 85 case reports that were analyzed in terms of direct and indirect effects of hospital incidents. Differences in the direct and indirect impact of hospital incidents were statistically assessed using the χ2 test and Fisher's exact test. Results: Thirty-nine reports (45.9%) involved direct impact on patient care, while 46 (54.1%) involved indirect impact on patient care. Most incidents that directly impacted patient care involved administrative staff writing prescriptions on behalf of a doctor (n = 24, 61.5%). Most reported errors that indirectly affected patient care were related to system administration, information, and documentation used by administrative staff (n = 22, 47.8%), including 14 cases of patient misidentification (16.5% of all cases examined).Conclusions: Incidents involving hospital administrative staff can lead to severe consequences for patients. As such staff are members of medical treatment teams, improvements in patient care may require the submission and review of more incident reports involving administrative staff.