Organizational Leadership Research Articles

Laissez-faire leadership: a comprehensive systematic review for effective education practices

This analysis addresses the knowledge gap on laissez-faire leadership in organizations. After reviewing 64 articles through the systematic literature review, the study finds that laissez-faire leadership, marked by minimal decision-making involvement, is generally associated with negative outcomes like reduced employee satisfaction and productivity. However, its impact can vary based on context, potentially fostering creativity in highly skilled and motivated teams. The study emphasizes the need for judicious application of this leadership style and suggests that school managers should discern when to use it, considering its suitability for different types of educators. Overall, the research contributes valuable insights for leaders aiming to optimize leadership strategies in diverse contexts.

Getting Acceptance for Tough Decisions

This article discusses research-based strategies that organizational leaders can use to effectively implement unpopular decisions and gain acceptance of necessary changes from employees and stakeholders. It outlines the importance of clear communication to explain the rationale and context behind tough choices. Leaders must be transparent in their decision-making process and involve stakeholders to address concerns and build ownership of outcomes. Addressing the negative emotions that arise and exploring alternative options or ways to mitigate impacts can help address psychological and practical issues. Enlisting champions and coalitions of supporters to reinforce the reasoning for decisions can boost consensus. Continued communication on outcomes and progress reinforces that the difficult period was necessary. Ultimately, navigating tough times requires combining these communication strategies with empathetic and honest leadership that cultivates trust and shared commitment to organizational goals and vision despite short-term hardship.

Elements Supporting Translation of Evidence Into Practice: A Model for Clinical Nurse Specialist and Nurse Scientist Collaboration.

To present evidence-based elements supporting the synergistic relationship between nurse scientists and clinical nurse specialists to improve the translation of evidence into practice. Using best-practice elements to support the improvement of evidence-based translation, we define the roles and synergies between nurse scientists and clinical nurse specialists within clinical environments. Five themes were identified in the literature review:● Although clinical nurse specialists and nurse scientists differ in focus and competencies, they are in key positions to collaborate to meet healthcare demands.● Clinical nurse specialists are well-equipped to implement the science developed by nurse scientists.● To meet the increased demands and complexity of the healthcare system and patient needs, organizational leadership must lend support to clinical nurse specialists and nurse scientist collaboration.● Clinical nurse specialists are well-positioned to foster interprofessional partnerships and generate opportunities for evidence-based project initiatives across healthcare disciplines.● Clinical nurse specialists should utilize professional models to inform practice to improve the review, translation, and implementation of research into practice. Projects conducted using a collaborative structure had a system-level impact and long-term sustainability capabilities. Additionally, projects were more likely to be disseminated by clinical nurse specialists within a formal structure.

Ethical leadership in health-care organizations - a scoping review.

The purpose of this study is to explore the impact of EL style on key variables in health-care settings. Very few studies investigate the impact and outcomes of EL on health-care organizations. Synthesis of evidence will assist health-care leaders in making informed decisions about the outcomes they can expect from practicing EL. Arksey and O'Malley's five-stage framework is used for conducting the scoping review. The databases include Scopus, Emerald Insight and Web of Science. A total of 22 studies were finally considered for scoping review. The data are presented in terms of years, sampling techniques, sample size, data collection methods, and the directional relationship of the variables with EL. Managers should be trained in EL style as it promotes the sustainability of the environment and organizations. Furthermore, EL should be promoted in health-care organizations as it improves employee resilience and voicing behavior and reduces instances of adverse events and medication errors, thus making the hospital a better and safer place. This is one of the studies investigating the EL implications for health-care managers.

Harnessing social marketing for interdisciplinary health management: enhancing public health outcomes

Abstract Social marketing in health leverages the principles of traditional marketing to influence behaviours that benefit individuals and communities. It involves using marketing techniques to promote public health initiatives, aiming to change attitudes and behaviours towards healthier choices. By strategically framing health messages, social marketing can effectively reach diverse populations, encouraging them to adopt practices that enhance their wellbeing. This approach not only increases awareness about health issues but also empowers people to take proactive steps in managing their health, ultimately leading to improved public health outcomes. Showcasing a forward-thinking approach to public health management, this plenary session seeks to shed light on the transformative role of interdisciplinary collaboration in enhancing health outcomes. Recognising that health and wellbeing are influenced by a myriad of actors beyond the healthcare sector, there is a growing imperative to empower professionals from diverse disciplines with health management principles. By effectively ‘social marketing’ health management to those outside the traditional health sector, such as in architecture, urban planning, construction, education, transportation, and manufacturing, health-oriented decision-making can be seamlessly integrated across these fields. The session will highlight innovative approaches for engaging non-health stakeholders in decision-making processes, leveraging the expertise of health management and public health professionals. By facilitating a dialogue between health professionals and experts from other sectors, the session will explore the potential and challenges of intersectoral partnerships, and challenge policymakers, health managers, and stakeholders in the health sector to actively engage non-health professionals in their pursuit of improved health outcomes for European citizens. Case studies from across Europe where interdisciplinary collaborations have led to social programming and infrastructure developments that enhance health and wellbeing will be presented. The case study ‘Compassionate leadership’ will delve into how organisation leaders can harness their health management capacity to foster a supportive environment that prioritises wellbeing. ‘Health-centric design in public spaces’ will demonstrate the impact of designing public areas with a focus on health, showcasing how thoughtful urban planning can significantly enhance community health. The third case study, ‘Architecture for better health and healing’ will highlight the role of architectural design in promoting health and recovery, emphasising the importance of creating spaces that support healing. Finally, ‘Educating to health’ will underline the significance of educating young people to healthy habits, sustainability, and physical and mental wellbeing, illustrating how this can lead to healthier communities. By fostering broader interdisciplinary collaboration, it is possible to unlock innovative solutions to health challenges and ultimately create healthier, more resilient communities across Europe. Moderator Tiago Correia Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Portugal, and Board Member of the EHMA Speakers/Panellists Marina Macchiaiolo Rare Diseases and Medical Genetics Unit, Bambino Gesù Children’s Hospital, Italy, and President of the Italian Committee for the United World Colleges Stefano Capolongo Department of Architecture, Construction Engineering and Built Environment (ABC), Politecnico di Milano, Italy

Fairer Training in public health, the UK FPH example

Abstract Background Public Health (PH) advocates for health equity and social justice. The UK Faculty of Public Health (FPH) is committed to tackling inequalities across the public health career pathway. The Fair Training project is a multi-phased programme which focuses on fair recruitment into PH, reducing differential attainment during PH training and postgraduate examinations. Objectives • Analyse available data from various sources; • Identify gaps in fair training culture and any biases; • Identify where support or interventions may best be focussed to minimise disadvantages; • Identify improvements in data that could be used to monitor actions; • Identify areas of good practice. Variables explored were demographic characteristics e,g, age, sex, ethnicity, disability status, professional background, candidate status (UK or overseas), place of primary qualification. Results Results show that candidates from ethnic minority backgrounds, those who are older, from international medical graduate backgrounds and backgrounds other than medicine are under-represented at the end of recruitment. Multivariable analysis of the diplomate exam shows that an attainment gap exists across increase with age, and those from black, Asian or white other ethnicity, professional background other than medicine, and overseas candidates. For the membership exam, multivariable analysis shows the attainment gap persists across those of increasing age and black ethnicity. Conclusions Recognising differential attainment as a structural problem requires organisational and individual leadership. Recommendations include an action plan to ensure: • Equality of opportunity for learning and career progression; • Collaborative working to eliminate discrimination in the design of education; • Ensure that training and the working environment are inclusive and diverse; • Inform future PH workforce planning; • Share good practice. FPH will implement the recommendations and share with other organisations and countries. Key messages • Structural causes of differential attainment during recruitment and training in public health do exist and should be mitigated. • FPH aims to promote Fair Training and excellence in public health practice.

The challenge of toxic leadership in realising Sustainable Development Goals: A scoping review

Orientation: Best human resource management (HRM) practices can play a crucial role in addressing unethical leadership in the form of toxic leadership by fostering organisational cultures where trust, integrity, and accountability are prioritised.Research purpose: The paper addresses how the HRM function can contribute to eliminating toxic leadership and its associated norms and thereby meet the objectives of Sustainable Development Goals 8 and 16.Motivation for the study: The prevalence of toxic leadership and the extent of the detrimental consequences for employees and organisational functioning is a key challenge in realising SDGs 8 and 16.Research approach/design and method: To conduct the scoping review, the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed, and selected databases were searched for peer reviewed empirical articles between 2014 and 2024. Results were summarised and thematically categorised with regard to the objectives of the paper.Main findings: Ethical leadership behaviours are presented as a key mechanism for offsetting the impact of toxic behaviours of organisational leaders. In order to achieve SDGs 8 and 16, the support and commitment from HRM practitioners are essential.Practical/managerial implications: Promoting ethical leadership and a conducive work environment demands attention in the following five areas of HRM practice: recruitment and selection; training and development; performance management; employee engagement and wellbeing; and organisational culture.Contribution/value-add: The review of existing literature on toxic leadership offers a succinct summary of different mechanisms and strategies that can be employed to counter these forms of leadership behaviours in organisations.

Leveraging Digital Resources: A Resource-Based View Perspective

In today's rapidly evolving digital landscape, organisations are challenged to strategically deploy digital resources to secure competitive advantage. Drawing upon the Resource-Based View (RBV) theory, this paper explores the intricate interplay between digital resources and organisational success. Through thematic analysis of empirical literature, the study delves into key facets such as data utilisation, digital platforms, technological capabilities, talent management, agility, and strategic partnerships. Methodologically, qualitative research techniques, notably thematic analysis, are employed to synthesise existing research findings. The study uncovered that human capital is pivotal in propelling digital transformation and fostering innovation. Organisational success in the digital era relies on implementing effective methods for managing digital talent, including recruiting, training, and keeping workers with digital competence. The study also highlights the strategic significance of digital resource utilisation within the RBV framework. Finally, the paper presents practical implications for organisational leaders seeking to harness digital resources effectively to achieve sustainable competitive advantage in the digital era. Findings underscore the strategic importance of digital resource utilisation in enhancing organisational competitiveness and driving long-term growth. The study contributes to understanding how organisations can optimally leverage digital resources within the RBV framework.

Enhancing Performance in Construction Project Management Teams

The seminar paper provides a pragmatic perspective of the topic of enhancing performance in construction project management teams. The paper provides a detailed collated review of several key areas pertaining to construction project management teams and their performance based on the findings of previous research. The study has focused on a range of aspects namely, leadership, competence and capabilities, effective communication, decision-making, interpersonal relationships and emotional intelligence, project management and governance approaches, trust, psychological safety, and team culture. Each sub-topic (aspect) has been structured in a manner that includes a brief introduction to the aspect, its importance for construction projects, the current state in construction projects, strategies, and approaches to eliminate the issues and contribute to increase in the team’s overall performance and finally, the novel strategies and tools pertaining to the focus area. The author anticipates that the content provided in this seminar paper shall be beneficial for effective decision making by organizational leadership and for the project leadership and the team to pay more consideration towards the strategies and approaches to enhance the elaborated aspects that are often overlooked in construction projects.

The Impact of HRM Practices on Employee Performance: A Study on Readymade Garments Sector in Bangladesh

This study explores the impact of Human Resource Management (HRM) practices on employee performance in the Readymade Garments (RMG) sector of Bangladesh, employing qualitative data collection methods to gain in-depth insights. As the RMG sector plays a pivotal role in Bangladesh’s economy, understanding how HRM practices influence employee performance is essential for organizational growth and effectiveness. Data were collected through semi- structured interviews with HR managers, team leaders, and employees from various RMG firms, as well as focus group discussions. The research focused on key HRM practices including recruitment and selection, training and development, performance appraisal, compensation and benefits, and employee relations. These practices were examined to understand their perceived impact on employee performance, such as job satisfaction, productivity and motivation. The qualitative analysis reveals that effective recruitment and selection practices are crucial in aligning employee skills with job requirements, leading to higher performance levels. Comprehensive training programs are valued for enhancing skills and boosting confidence, which positively affects productivity. Transparent and fair performance appraisals are seen as motivating employees and fostering a sense of achievement. Competitive compensation and supportive employee relations contribute to job satisfaction and commitment, driving overall performance. The findings indicate that while HRM practices in the RMG sector are generally effective, there are areas for improvement. This research provides actionable insights for HR professionals and organizational leaders aiming to improve performance outcomes in the RMG sector.

An exploration of factors leading to readiness for organizational health literacy change in community-based health organizations.

Healthcare systems have a responsibility to improve organizational health literacy (OHL) to increase health equity. This study explored two organizational cultural factors, leadership support and staff buy-in, for organizations planning OHL change. Ten community-based health organizations participated in an OHL program. The study design was mixed methods. The qualitative inquiry was interviews with senior leaders to explore awareness of OHL and: impetus to transform, leadership commitment, staff engagement, alignment to organizational goals, and integration of health literacy change with current practices. The quantitative assessment was the Organizational Readiness for Implementing Change (ORIC) questionnaire to assess staff's perceptions about OHL change readiness. Senior leaders articulated the effects of low health literacy in their patient and client population. Support for OHL change was seen at both leadership and staff levels. Impetus for change was primarily a response to a community need or for quality improvement. Most of the non-clinical organizations had higher ORIC scores than the clinical organizations, indicating a perceived higher level of readiness for OHL change. Leadership commitment and staff buy-in are important factors of readiness for OHL change. A novel finding is that community-based health organizations are able and willing to engage in OHL change.

Thriving minds, thriving workplaces: unleashing creativity through psychological wellbeing and psychological capital

PurposeThis study examines the complicated relationship between psychological wellbeing, joy at work, creative ability and the mediating influence of psychological capital, drawing insights from self-determination theory within the context of the banking sector.Design/methodology/approachThe study utilized random sampling to gather comprehensive data from 465 banking employees. Following data collection, structural equation modeling was employed to test the hypotheses formulated based on the collected data.FindingsFindings underscore a significant association between psychological wellbeing and both joy at work and creative ability within the banking sector. Moreover, the study elucidates that psychological capital acts as a crucial mediator, illuminating the pathway through which psychological wellbeing influences joy at work and subsequently enhances creative ability.Practical implicationsThis research offers valuable insights for organizational leaders and policymakers, emphasizing the imperative of prioritizing psychological wellbeing initiatives and nurturing positive work environments to enhance employee satisfaction, productivity and innovative contributions within the banking sector.Originality/valueThe application of self-determination theory as a theoretical framework provides a robust foundation for understanding the dynamics between psychological factors and workplace outcomes. The banking industry, often characterized by high stress levels and demanding work environments, stands to benefit substantially from interventions aimed at fostering psychological wellbeing. By cultivating positive mental health and capitalizing on joy at work, organizations can stimulate employee creativity ability, thereby fostering innovation and adaptive problem-solving capabilities crucial in the contemporary banking landscape.

Organizational evidence-based practice culture, implementation leadership, and nurses: A bidirectional mediation model.

This study aimed to explore 1) factors that influenced the evidence-based practice competencies and behaviors of clinical nurses and 2) the interaction between the organizational evidence-based practice culture, head nurses' implementation leadership, and nurses' evidence-based practice competencies and behaviors. The significance of organizational evidence-based practice culture and head nurses' implementation leadership in enhancing nurses' evidence-based practice competencies and behavior is widely recognized in healthcare settings. However, there is limited knowledge of how these factors influence nurses' evidence-based practice competencies and behavior. A cross-sectional survey was conducted at 10 hospitals in China. Data were collected via online questionnaires from October to December 2020, utilizing social characteristic questionnaires, the Evidence-Based Practice Questionnaire, the Organizational Culture and Readiness Scale for System-wide Implementation ofEvidence-Based Practice, and the Implementation Leadership Scale. All data were imported into the IBM Statistical Program for the Social Sciences (SPSS) 27.0 and PROCESS version 4.1 macro on SPSS for statistical analysis. The design and reporting of our study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Checklist. We received 1047 (99.15%) valid questionnaires. The multiple linear regression analysis showed that significant factors were organizational evidence-based practice culture, implementation leadership, and years of experience in nursing. After controlling for the impact of the covariate (years of experience in nursing), it was found that organizational evidence-based practice culture partially mediated the relationship between head nurses' implementation leadership and nurses' evidence-based practice competencies and behaviors. Additionally, head nurses' implementation leadership partially mediated the relationship between organizational evidence-based practice culture and nurses' evidence-based practice competencies and behaviors. Organizational evidence-based practice culture, head nurses' implementation leadership, and years of experience in nursing significantly predict nurses' evidence-based practice competencies and behaviors. Organizational evidence-based practice culture and head nurses' implementation leadership mutually mediated their influence on nurses' implementation of evidence-based practice. Head nurses should proactively seek opportunities to enhance their implementation leadership, such as participating in training programs (e.g., mentoring and coaching programs) and attending conferences, workshops, or seminars on implementation leadership. Policymakers should also consider providing more policy support for implementing leadership development and cultivating a positive evidence-based practice culture.

Dr. Meena and mission maternal health: building allies in the government hospital

Research methodology The case study is based on field data, including in-depth semi-structured interviews with the main protagonist and related stakeholders of a large government hospital in Western India. After informed consent, the interviews with the stakeholders were conducted, transcribed and analyzed verbatim. In addition, secondary data from policy reports, newspaper articles and government websites was used to create the case. Since the protagonist works in the government system, her identity and other identifying information are disguised to maintain confidentiality. Case overview/synopsis The case study investigates the leadership challenges in a healthcare facility/hospital in public health. It traces the evolution of Dr Meena Sharma (Dr Meena), a leader in the government hospital ecosystem facing challenges such as infrastructural deficiencies, manpower deficit, healthcare bureaucracy and heavy patient load. This first-generation medical practitioner who transitioned from a private practice to a governmental one juggles balancing her demanding clinical practice, administrative responsibilities and teaching in the government hospital with her family responsibilities setup. However, in the wake of the upcoming LaQshya – Labour Room Quality Improvement Initiative by the Ministry of Health & Family Welfare, she strives to put together and motivate her team to work toward improving the quality of care during delivery and the immediate postpartum period at her hospital. Various issues arise in the organizational leadership for a woman leader such as adopting appropriate leadership style and using appropriate motivation and communication strategies for optimal performance. Complexity academic level The case study is aimed at teaching/training a) departmental heads of public and private hospitals, b) health program managers at higher and middle-level leadership roles, c) health policymakers at various levels in the government and other organizations and d) graduate and postgraduate students of public health, hospital management/administration. In addition to this, it can also be used for general management programs to teach organizational behavior, communication and leadership courses.

Exploring Leadership Excellence and Accountability in Organisational Dynamics: A Comprehensive Analysis in Nigeria

This study explores the relationship between leadership excellence and accountability within organisations in Plateau State, Nigeria, and their combined impact on organisational culture and success. The research adopts a mixed-methods approach, utilizing both quantitative and qualitative data to provide a comprehensive analysis. Quantitative data were gathered through a structured questionnaire, revealing moderately positive perceptions of leadership practices, with a particular emphasis on fostering continuous learning and responsibility among leaders. Qualitative data, obtained through thematic analysis of open-ended responses, highlight effective leadership practices such as transparent communication and collaboration, as well as challenges in implementing accountability measures, including resistance to change and resource limitations. The Integration of quantitative and qualitative findings underscores the significant influence of leadership on accountability and, consequently, on organisational culture. The study also addresses social desirability bias by assuring participants of their anonymity and encouraging honest feedback. The findings contribute to academic discourse by providing localized Insights into leadership and accountability within the specific context of Plateau State, Nigeria. Practical recommendations include investing in leadership development programs, enhancing clarity in accountability measures, promoting continuous learning, addressing communication gaps, and prioritizing employee engagement. This research offers a roadmap for organisational leaders aiming to foster a culture of accountable leadership and drive organisational success in dynamic business environments.

The Effect of Employee Engagement on Employee Performance by Moderation of Generational Characteristics of Employees in Private Agencies

Employee engagement is an important issue that is the main concern of the organization's leaders in managing its employees. The changing characteristics of the employee generation are becoming a specific challenge for human resource management. Employees who are engaged with their work will exert all their abilities, efforts, and thoughts and significantly contribute, where the engagement and personal characteristics possessed by employees in carrying out their work can directly impact their performance. This study aimed to analyze employee engagement's effect on employee performance by moderating the generational characteristics of private agency employees in the City of Padang, West Sumatra. Data was collected through questionnaires distributed to 100 employee respondents working in private institutions in the city of Padang, with purposive sampling technique. Then, the data is processed using the Partial Least Square-Structural Equation Modeling (PLS-SEM) method. The results of this study indicate that employee engagement generational characteristics (Y and Z generation) have a positive and significant effect on employee performance. Generational characteristics (Y and Z generation) also positively and significantly impact employee engagement. Generational characteristics do not moderate the relationship between employee involvement and employee performance, but directly employee engagement and employee performance can be improved with generational characteristic variables. Organizational leaders should pay attention to employee engagement and the characteristics of the generation of employees and can make it a potential to improve employee performance.

Adoption of Lean Construction and AI/IoT Technologies in Iran’s Public Construction Sector: A Mixed-Methods Approach Using Fuzzy Logic

The construction sector in Iran faces substantial inefficiencies, including high material wastage, posing environmental and economic risks. This study investigated the adoption of Lean Construction (LC) practices and AI/IoT technologies in Iran’s public construction sector using a mixed-methods approach. This research examined the organizational, technical, and infrastructural factors across four key provinces—Tehran, Isfahan, Khorasan Razavi, and Fars—and employed fuzzy logic to address the uncertainties in adoption decisions. Data from 28 key stakeholder interviews were analyzed using Python 3.9, with libraries such as Pandas 1.3.3, NumPy 1.21.2, and skfuzzy 0.4.2 for the statistical analysis and NVivo 12 for the thematic coding. The analysis revealed that organizational readiness and leadership support were the critical drivers of adoption, particularly in Isfahan and Khorasan Razavi, which exhibited the highest adoption likelihood scores (0.5000). Tehran and Fars showed slightly lower scores due to regulatory barriers and financial limitations. The findings highlight the need for targeted leadership training, regulatory reforms, and infrastructure investments to accelerate the adoption of these technologies. This study aligned with the Sustainable Development Goals (SDG 9: Industry, Innovation, and Infrastructure and SDG 11: Sustainable Cities and Communities) by offering practical recommendations for advancing sustainable practices in Iran’s construction sector. The insights provided have broader implications for other developing economies facing similar challenges, contributing to global efforts toward sustainable development.

Preparing a Globally Competent Workforce: A Mixed Methods Study of an Innovative Co-Curricular University Program

Problem Human resource development (HRD) scholars and practitioners have long sought ways to develop employees to meet the needs of globalized workplaces. However, given that many employers expect employees to possess global skills before they begin working, it is incumbent upon HRD educators in higher education contexts to develop and implement innovative programs to enrich global competence, which includes the knowledge, skills, experience, and mindset required for global work. Solution This mixed methods study describes and explores the efficacy of an innovative co-curricular program, the Global Competence Enrichment Program, designed to enhance the global competence of American and international graduate students enrolled at a higher education institution in the United States through a mutual intercultural learning process. Stakeholders Stakeholders include HRD scholars and practitioners as well as organizational leaders interested in designing and implementing HRD programs around global competence enrichment.

The Influence of Perceived Organizational Support, Transformational Leadership, and Work Motivation on Teacher Performance at XYZ Elementary School, North Jakarta

A school is an organization that operates in the field of education as a place where the learning process occurs for students to obtain education from teachers. Teachers at the forefront have an important role in advancing and improving services in schools. To support optimal performance, it is very important for a school leader to have strong organizational support, good abilities in managing the school, and able to increase and maintain teacher motivation. Researchers conducted to find out how perceived organizational support, transformational leadership, and work motivation influence teacher performance at SD XYZ North Jakarta. This research uses a quantitative research approach using the PLS-SEM method to analyze the influence of path coefficients on the variables studied. The respondents of this research were all 118 teachers at SD XYZ North Jakarta who filled out a survey using saturated sample data collection via the Google Form application. The data obtained was analyzed using SEM (Structural Equation Modeling) with the PLS 3.0 application. The results of this research show that perceived organizational support, transformational leadership, and work motivation have a positive effect on teacher performance.

Payment and billing strategies to support methadone take-home medication: Perspectives of financial leaders of opioid treatment program organizations in New York State

IntroductionRecent federal regulatory changes governing the delivery of methadone treatment for opioid use disorder at Opioid Treatment Programs (OTPs) support continued practice changes towards greater and flexible methadone take-home medication. Existing payment models for OTPs were closely tied with onsite medication administration and thus misaligned with the need to conduct more and flexible take-homes. This study aims to understand OTP organizations' experience with the newly created OTP bundled payment model in New York State as an alternative to the pre-existing per-service payment model during 2020–2023 to inform financing strategies to support and sustain practice changes. MethodsThe study conducted semi-structured interviews with financial leaders and staff from OTP organizations in New York State. Snowball sampling supplemented purposeful sampling of OTP organizations based on their billing practices by. Qualitative data from 12 interviews (with 11 OTP organizations and 1 trade organization) were analyzed with an integrated (inductive and deductive) approach to derive themes. ResultsStudy informants recognized that the bundled payment model served to protect revenue in a time when OTPs had to pivot quickly to increase take-home medication to patients. Informants described a wide spectrum of practices to operationalize billing in the alternative payment systems, revealing confusion with the billing rules and significant logistical and technical challenges. Informants expressed concerns regarding the substantial difference between the full bundled rate, paid in weeks with one or more qualifying services, and the medication-only rate, reporting that extended (2 weeks or more) take-homes might not be sustainable under the two-tiered model with the low medication-only rate and advocating for a single bundled rate. Informants believed that increased take-home medication and federal regulatory changes had profound implications for the delivery of counseling services, the counselor workforce, and financial viability for OTPs. ConclusionsOur study of OTP organization experience in New York State provided data on OTP organization perspectives regarding the potential revenue-protecting effects of bundled payments and generated insights to inform future research and policy experimentation to support flexible take-home medication. Future implementation studies are needed to better understand the roles of financing strategies at large in supporting clinical practice changes in substance use disorder treatment.