Clinical champions are a known strategy for implementing evidence-based practices; however, their application in de-implementing potentially inappropriate medications (PIMs) among persons with dementia is underexplored. We conducted a pragmatic cluster-randomized clinical trial of a champion-led deprescribing intervention in accountable care organization (ACO) primary care settings. To (1) understand clinical champions' perspectives of their deprescribing projects and (2) identify key contextual factors that influenced champions' deprescribing PIMs for persons with dementia within ACO primary care. A qualitative study guided by the de-implementation outcomes framework. Clinician champions who engaged in deprescribing projects. Data sources included transcripts from monthly learning calls and semi-structured interviews. All champions were invited to participate in learning calls and semi-structured interviews. The 30- to 60-min interviews were conducted using a semi-structured guide. We coded transcripts and performed thematic analysis to identify overarching themes. Eleven champions participated. Feasibility and fidelity of deprescribing were commonly undermined by external and organizational disruptions. Five contextual factors influenced champions' experiences: limited organizational readiness, lack of information technology infrastructure to support data access and patient identification, the importance of relationship-building and care coordination, the dyadic nature of deprescribing involving care partners, and the pharmacist's role as a multidisciplinary liaison. Champions employed adaptive, communication- and relationship-centered strategies to support deprescribing efforts. Champion-led deprescribing for persons with dementia is shaped by key contextual factors within ACO primary care settings. Dementia-specific training helped clinicians tailor deprescribing to local needs, but sustained efforts require supportive organizational structures, including ongoing education, accessible clinical data, and multidisciplinary collaboration. Primary care clinicians are uniquely positioned to lead personalized deprescribing conversations while pharmacists serve as liaisons with providers, patients, and care partners to coordinate deprescribing. Interventions that align with value-based care principles may strengthen system-level coordination and promote safer medication management in dementia care. ClinicalTrials.gov ID: NCT05359679.

Background: Blood stream infection is a predominant cause of morbidity and mortality in Bangladesh and needs urgent treatment with antimicrobial drugs. Blood culture is the gold standard for the diagnosis of blood infection. Patient's final outcome might be improved with detailed and organized surveillance studies on bloodstream isolates and their resistance. The present study deals with the isolation of blood culture isolates from patients of a hospital in Chattogram,Bangladesh and their antibiotic susceptibility pattern. Materials and methods: A purposive cross sectional retrospective study was conducted with a total 100 suspected bacteremia patients in 6 months duration in different lab of Chattogram to determine bacteriological profile of blood culture and antibiogram of the isolates. Bacterial isolates and their antibiotic sensitivity test were done according to standard microbiological techniques. Results: Approximately 53% of the cases are female and 75% in the under 5 years of age group. 36% of the culture isolates were Acinetobacter and other common isolates were Klebsiella (22%), Pseudomonas (18%), Salmonella typhi (17%), Staphylococcus aureus (4%), E.coli (3%). However, all the tested isolates were found mostly sensitive against Vancomycin, Gentamycin, Tazobactum. Penicillin had the highest overall resistance of (100%), followed by Ampicillin (100%) and Ceftazidime (90%). Cefepime, Cefuroxime, Cefixime, had overall resistance rates of 89%, 85%, 83% respectively. Highest drug resistance was found with Ampicillin (100%) and Penicillin (100%) against Acinetobacter. There were no isolates completely resistant to all the antibiotics tested. Conclusion: This study highlights that surveillance detection of causative agents of blood stream infections and their antibiogram should be done regularly in the hospital.We expect our present work will be helpful for the healthcare professionals to provide improved treatment. Chatt Maa Shi Hosp Med Coll J; Vol.24 (1); Jan 2025; Page 67-71

Organizations increasingly face mounting pressure to improve operational efficiency while simultaneously pursuing long-term business sustainability amid volatile markets, supply chain disruptions, and growing environmental and social accountability. Despite this urgency, workflow optimization initiatives are frequently implemented independently of supply chain optimization efforts, resulting in fragmented decision-making, misaligned performance metrics, and suboptimal sustainability outcomes. This study examines how the strategic integration of workflow and supply chain optimization can enhance operational performance, supply chain resilience, and sustainability outcomes in a real-world organizational context. Using an in-depth case study of a mid-sized manufacturing organization, this research analyzes the firm’s transition from functionally siloed operational improvements to a coordinated, end-to-end optimization approach. Data was collected through semi-structured interviews with key stakeholders across operations and supply chain functions, analysis of internal operational and supply chain performance records, and review of sustainability and environmental impact reports. A triangulated analysis was employed to assess changes in performance before and after integration. The findings reveal that aligning internal workflows with upstream and downstream supply chain processes led to significant reductions in cycle time and process variability, improved inventory turnover and service levels, and stronger supplier collaboration and coordination. Importantly, these operational and supply chain improvements were accompanied by measurable sustainability benefits, including reduced material waste, lower energy consumption, and decreased transportation-related emissions. The results suggest that sustainability gains were not incidental but rather emerged as a direct outcome of integrated decision-making and aligned performance incentives. This study contributes to the operations and supply chain management literature by providing empirical evidence on the role of workflow supply chain integration in achieving sustainable performance improvements. It extends existing research by demonstrating how integration of mechanisms, governance structures, and shared metrics can translate efficiency gains into long-term sustainability outcomes. From a practical perspective, the study offers a structured framework and actionable insights for managers seeking to move beyond isolated optimization initiatives toward integrated, sustainability-driven operational strategies.

Objective: Conduct an internal and external diagnosis of the organization2, identify the problem/opportunity through a problem tree, and determine the type of strategy developed and implemented and its impact on organizational performance. Methodology: The problem/opportunity was identified based on 25 semi-structured interviews with actors involved in the value network, and the environmental analysis was performed. The type of prevalent strategy was determined, and a matrix Eliminate-Reduce-Raise-Create was created to reformulate a new strategy. Results: The value network analysis highlights the relevance of suppliers that are not partners, almost equally as the partners. In addition, the organization has two sales channels of similar importance: fresh market and processed avocado. The last recorded a growth of eight times in 2013-2022. However, the organization has a vision focused predominantly on the first channel, even though they cannot position themselves with an advantage due to the lack of their capabilities, aside from the high competition that makes them fight with 97 packinghouses. The organization must leverage its experience and strengths by designing an added-value product to leave the red ocean. Implications: Implementing the new business line with a differentiated product would permit the organization to participate in a blue ocean. Conclusions: The organization's leaders do not consistently conduct environmental analysis to formulate strategy, noticing opportunities and internal capabilities. Keywords: Strategy, processed avocado, added value 2From here on it will be referred to as “La organización” for confidentiality reasons.

Purpose This study aims to examine the managerial practices involved in the staging of the York Cycle of Mystery Plays (1376–1569), developed during a period of profound social and economic transformation. It aims to contribute to the understanding of the historical evolution of cultural management and organization. Design/methodology/approach Research proceeded through three phases: defining core Western arts management functions, selecting the historical case using rigorous criteria and conducting extensive literature review and archival research on the York Cycle. Findings The York Cycle production and staging required sophisticated organizational practices, compounded by the profound socio-economic changes which followed the Black Death. These practices are reflective of persistent challenges in cultural production: securing funding, ensuring artistic quality, planning and managing complicated logistics and mediating between competing interests. They illuminate how medieval guilds of York developed an organizational form that could endure uninterruptedly for two centuries, across widely varying conditions. Research limitations/implications The organizational innovations of the York Cycle indicate that these medieval cultural producers developed and implemented solutions to persistent problems in cultural production. Future research should examine how these problems were negotiated in other historical and cultural contexts, to develop a more robust understanding of how sustainable structures for collective artistic and cultural expression emerge. Practical implications The historical analysis of how arts and culture have been organized can reveal patterns that are relevant to contemporary arts management practice. The York Cycle endured for 200 years thanks to a diversified funding model, adaptive governance and intentional and systematic community engagement. Arts and culture organizations of our time, facing similar turbulence and challenges, can be inspired by how the problems of resource fragility, complex partnerships and fostering community engagement were tackled historically. Social implications Sophisticated cultural organization predates modern arts management by centuries. By examining how one medieval community developed organizational solutions to persistent challenges of creative enterprise: diversified funding, adaptive governance and community engagement. The study suggests that using a similar methodological approach may yield a deeper understanding of cultural organization forms and strategies. Originality/value While the DNA of artistic disciplines are well-documented, the historical analysis of cultural organization remains largely unexplored. This study demonstrates how examining organizational practices around cultural production through historical case studies can illuminate collective solutions to coordination problems in cultural production. This provides a foundation for understanding cultural organization as an (evolving) response to persistent human expressive needs, rather than to recent professional and environmental developments. The York Cycle provides a historical case study of medieval cultural organization that reveals challenges, patterns and solutions that can contribute to the understanding of how arts and cultural management and organization have developed.

ABSTRACT This article examines the socio-political dynamics of 1980s Brazil through Morangos Mofados (1982) by Caio Fernando Abreu. Composed of short stories, the collection portrays alienation, emotional fragmentation, and existential uncertainty within a society shaped by political transition, neoliberal reforms, and the emerging AIDS crisis. Using contextual, environmental, and psychological frameworks, the article analyzes how Abreu’s literary form – including free indirect discourse, narrative fragmentation, and lyrical language – reveals the affective dimensions of social disintegration. The stories reflect lived experiences of marginalization while also enacting resistance to normative frameworks that regulate recognition, visibility, and emotional expression. The article situates Morangos Mofados as a diagnostic literary intervention that highlights epistemic and affective blind spots in mainstream organizational studies. By linking Abreu’s narrative strategies to debates in Critical Organizational Studies (COS), the article argues that literature can function as both an epistemological lens and a conceptual resource for rethinking alienation and identity in contemporary organizational contexts.

This article examines the contemporary development of qassaaneq, which is the manual removal of fat from sealskin using an ulu (crescent-shaped knife) in Iserdor (Isortoq), East Kalaallit Nunaat, exploring the theme of fluidity and adaptability of Kalaallit (Greenlandic-Inuit) gendered roles in sealskin production. This study contributes to management and organization studies by centering Kalaallit perspectives on work and organizing. Mainstream knowledge production in the field is constructed by coloniality which marginalizes non-Western and Indigenous ways of knowing, doing, and understanding work and organization. Drawing on fieldwork, this study explores how the Iserdor community organizes qassaaneq for sealskin trade, examining the tensions and efforts to sustaining qassaaneq and their visions for future. The findings reveal how the community navigates tensions between colonial structures and their Indigenous worldview, offering insights into alternative ways shaped by their values and practices.

Positive psychology has become an essential field in organizational studies, significantly impacting employee well-being and performance. This paper explores the role of positive psychology in the organizational environment, highlighting the benefits of applying its concepts, such as job satisfaction, positive leadership, and a development-oriented organizational culture. The present study analyzes the effects of strategies based on positive psychology in improving the work climate and increasing productivity. The applied research includes a questionnaire distributed to employees of an IT company, aiming to correlate the level of satisfaction with organizational behaviors. The results confirm the initial hypotheses, demonstrating that employees who exhibit a high level of satisfaction have greater productivity and more harmonious interpersonal relationships. In conclusion, integrating practices from positive psychology can significantly contribute to long-term organizational success.

Today, accounting (financial) reporting is considered a fundamental element of any organization’s management and operational system. The relevance of this study is determined by the upcoming transition of Russian organizations to new federal accounting standards, which will come into effect in 2026. These changes require a revision of approaches to the preparation and presentation of accounting (financial) statements, making the study of organizations’ adaptation to these new requirements particularly important in the current environment. The following methods were used in the study: analysis and synthesis, comparison, and logical and systems approaches. This article explains that the implementation of the federal accounting standard FSBU 4/2023 “Accounting (Financial) Reporting” in 2026 will entail significant changes in approaches to the preparation, presentation, and disclosure of organizations’ financial information. Furthermore, it was concluded that the implementation of FSBU 4/2023 “Accounting (Financial) Reporting” requires organizations not only to adapt their methodologies but also to pay special attention to ensuring the reliability and accuracy of the data presented. Failure to comply with established requirements or the presence of misstatements in reporting may lead to a violation of the principle of a fair presentation of the organization’s financial position and, consequently, to a distortion of the economic decisions of users. Therefore, ensuring the transparency and accuracy of accounting (financial) reporting is a prerequisite for maintaining the trust of investors, creditors, and other stakeholders. The results of the study are of interest to a wide range of users, including both practicing accounting and finance professionals and representatives of the academic community working on accounting and reporting issues. The findings and recommendations can be used in the educational process at higher education institutions, as well as in the practical activities of accounting departments at modern organizations when adapting to the requirements of the new federal accounting standards.

Spatial sequencing technologies enable the single-cell-level study of molecular organization in tissues. Revealing such spatial patterns relies on accurate cell segmentation. In complex tissues with dense cell packing, segmentation based solely on nuclear staining is insufficient for accurate cell boundary detection. This limitation arises because accurate segmentation necessitates the delineation of cell morphology, which is driven by molecular activities such as cytoskeletal dynamics, cell-cell adhesion, and intercellular signaling. Thus, integrating molecular information, including gene or protein expression, has the potential to improve segmentation, but remains computationally challenging. To address this, we developed SegJointGene, a deep learning framework that jointly performs cell segmentation and spatial gene prioritization by integrating nuclei-based images with spatial gene or protein expression data. SegJointGene designs an information-entropy-guided convolutional neural network together with a computational information discarding score to identify genes that are important for cell-type-specific segmentation. The model iteratively refines gene prioritization and cell boundaries, producing convergent segmentation results along with prioritized spatial genes or proteins across cell types. We applied and benchmarked SegJointGene on various real spatial datasets, including spatial transcriptomics from the mouse hippocampus and distinct regions of the whole mouse brain, as well as spatial proteomics data from human tonsil. Across datasets, SegJointGene outperformed existing methods by 5-20% in accurately assigning molecular signals to cell boundaries. Robustness analyses further demonstrated stable performance across varying gene numbers and imaging resolutions. In addition, the genes prioritized by SegJointGene were enriched for structural, developmental, and synaptic signaling pathways, supporting their relevance to spatial tissue organization.

Antifragility challenges conventional thinking by proposing that adversity is not merely to be survived but actively used to promote growth. This scoping review synthesizes 18 emerging research studies focused on antifragility in human systems across disciplines, distinguishing antifragility from resilience and robustness and highlighting key empirical gaps, particularly in psychological research. During the screening process, articles were categorized as human or non-human systems. Non-human systems (n = 29; e.g., robotics, logistics, information systems, urban planning, artificial intelligence) were excluded from synthesis to align with the review's focus on human domains (e.g., psychology, leadership, coaching, health). Drawing from biology, psychology, and organizational studies, the review summarizes applications in mental health, performance, and quality of life. Findings emphasize the proactive nature of antifragility, in which stressors are intentionally engaged to strengthen capabilities. Biological concepts like hormesis and psychological frameworks such as post-traumatic growth align with mechanisms relevant to growth through adversity. Yet empirical studies remain scarce, underscoring the need for robust measurement tools and longitudinal designs. Future directions include refining antifragility as a state, trait, or process, developing dose-specific models, and exploring biopsychosocial correlates. Embracing antifragility could transform how individuals and systems confront challenge, not by resisting breakdown, but by evolving beyond it.

Abstract How do entrepreneurs embody and enact hope as a motor for ethical agency—agency that builds one’s own and others’ capacities and capabilities to overcome a painful present? This study puts hope at the center of theorizing around the activities of entrepreneurs who leverage it both as a way to sketch a new life for themselves and to sell it to others. Through the case of illness entrepreneurs—recovery coaches for those suffering from chronic illnesses—we observe the moral struggles involved when hope becomes framed within the logic of the market. Recovery coaches at once embody hope (as formerly sick people who have recovered), neatly package and sell it (as entrepreneurs), and manifest it (opening up new spaces of possibility for themselves). The work involved in balancing these threads requires constant realignment of the entrepreneurs’ own hopes for a new life and their care for others. We show how, through these moral struggles, hope opens up new spaces of possibility and imbues people—both entrepreneurs and their clients—with the agency to move toward those new horizons. Conceptualizing the complex entanglements of hope, care, and ethical agency, our study represents a foray into recent calls for assembling and theorizing the ‘architecture of hope’ in organization and entrepreneurship studies. We also discuss whether this entrepreneurship, balancing hope and care to enable ethical agency, opens up new ways of understanding morality and agency in market contexts.

Challenging the ‘wall of text’ in academia, we explore how drawing as a practice for knowledge creation can lead to new academic insights. The empirical data is based on our own drawing practices in research within higher education and organizational studies. Using drawing as an ethnographic approach, graphic facilitation, and care aesthetics, we invite scholars and practitioners alike to explore how drawing can enrich academic inquiry processes across fields. Through examples, we take a point of departure in our own engagements with participants in drawing exercises and dialogues relevant to their contexts. We analyse significant perspectives on how to tackle different situations when drawing is applied as a research practice. We are particularly interested in exploring how the act of “daring to draw” is negotiated in moments when participants experience frustration, discomfort and doubt about their own drawing abilities, or even choose to decline our invitation to take charge of the pens and pencils themselves. In these situations, drawing emerges as a relational practice shaped by interactions, emotions, and roles within the research setting. Rather than viewing the penholder as the sole research drawer, we propose understanding drawing as a shared and negotiated activity, where meaning is co-created through participation, hesitation, and refusal alike. This paper argues that when drawing is employed as a research method, it not only generates valuable context-sensitive knowledge but also demands careful attention to the evolving roles and actions of both researchers and participants.

Purpose This paper aims to examine how ethics committee documents shape the negotiation of ethical dilemmas in qualitative management and organisational studies (MOS). We show how biomedical logics of harm reduction, inherited from bioethics, become materialised in forms, decision letters and correspondence, producing both protective effects and unintended constraints. Design/methodology/approach Using a case study of a project on migrant brick kiln workers in India, we analyse application forms, decision letters and emails through Fairclough’s critical discourse analysis (CDA), treating these as organising texts that define permissible knowledge and language. Findings Ethics documents enact three dynamics that constrain qualitative inquiry: epistemic risk (foreclosing knowledge by privileging immediate utilitarian benefit), political risk (sanitising critical terms such as “modern slavery”) and relational risk (neglecting harms that arise unpredictably in encounters). While committees seek to protect participants and researchers, these textual practices also channel ethics into compliance rituals and depoliticised categories. Originality/value By analysing documents as the unit of study, this paper shifts debates from adversarial critique to constructive reform. We argue for a dialogic model of review that retains safeguards while recognising researchers as reflexive ethical agents. Our contribution is twofold: extending QROM’s debates on reflexivity by framing it as both resistance and common ground with committees and advancing research governance scholarship by showing how ethics documents themselves organise epistemic, political and relational risks.

As organizations navigate unprecedented technological, social, and economic shifts, the workplace of 2026 is being shaped by forces that demand both strategic foresight and operational courage. This article synthesizes insights from two major CHRO leadership summits, 150+ organizational case studies, and extensive conversations with HR thought leaders to present ten evidence-based predictions for the evolving workplace. These predictions span AI integration, people analytics transformation, boundary-less work models, skills-based organizing, systemic wellbeing design, reimagined leadership, HR's orchestrator role, culture as practice, stakeholder capitalism, and the emergence of HR 3.0. While these trends are well-documented in research literature, the critical challenge lies not in recognizing them but in executing them with courage and commitment. Organizations that successfully navigate these shifts will move beyond conceptual frameworks to embedded operating models that create measurable value for multiple stakeholders. This article provides evidence-based interventions, organizational narratives, and forward-looking capabilities required to transform insight into action.

This study aims to examine the concept of organizational tradition within an independent analytical framework. While tradition has long been discussed in the social sciences through ritual, symbol, narrative, and memory, it has often been treated as synonymous with organizational culture in organizational studies, which has overshadowed its analytical potential. The study adopts a conceptual review method, systematically analyzing key literature on culture and tradition to develop a comparative framework. Within this framework, the article distinguishes between culture and tradition, highlighting the structural components of organizational tradition and its functional dimensions. Accordingly, organizational tradition is positioned not as a sub-element of culture but as a distinctive institutional structure that shapes normative orders and identity formation processes. Future research in this field can contribute to a better understanding of the analytical potential of organizational traditions as well as their practical implications.

The purpose of this study is to investigate how despotic leadership impacts workplace incivility through increased workload and to determine whether distributive justice moderates this relationship within selected higher education institutions in Rawalpindi and Islamabad. These two cities were specifically selected due to their significant representation of educational institutions, making them suitable samples for understanding dynamics within Pakistan’s higher education context. This study examines the relationship between despotic leadership (DL) and work place incivility (WPI) within the higher education sector of Rawalpindi and Islamabad. Specifically, it explores the mediating role of workload and the moderating role of distributive justice in this relationship. Grounded in the Conservation of Resources (COR) theory, this research extends existing literature by elucidating how resource depletion and accumulation shape employee behavior. A quantitative, cross-sectional survey-based methodology was utilized, collecting responses from 381 employees from higher education institutions located in Rawalpindi and Islamabad, with data analyses through IBM SPSS 27 and AMOS 22 using Confirmatory Factor Analysis (CFA), reliability tests, ANOVA, descriptive statistics, and correlation, and process macro direct effects, mediation, and moderation analyses to examine the proposed relationships. Indicates that despotic leadership significantly contributes to workplace incivility, primarily through increased workload. However, distributive justice serves as a mitigating factor, attenuating the adverse effects of workload on workplace incivility. The results confirm the mediating role of workload and the negative moderating influence of distributive justice. These insights underscore the necessity for organizational leadership to adopt more equitable and ethical management practices. Additionally, human resource policies should emphasize fairness and actively address complaints related to unfair treatment. The study posits that maintaining fairness in workload distribution, enhancing hiring practices to deter the emergence of despotic leaders, and establishing secure mechanisms for reporting grievances are critical steps for organizations seeking to curb workplace incivility. It underscores the centrality of distributive justice in mitigating negative interpersonal dynamics and fostering a more positive organizational climate. Moreover, initiatives such as impartial investigations and civility training programs are identified as pivotal in strengthening workplace relationships and preventing the escalation of retaliatory behaviours that contribute to a spiraling effect of incivility. Our study is limited by its focus on higher education institutions in Islamabad and Rawalpindi, suggesting the need for future research across broader sectors, cities, and global contexts. This research extends prior work in organisational behaviour and leadership studies, particularly by building upon the Conservation of Resources (COR) theory and the workplace incivility literature. It empirically examines the effect of despotic leadership on workplace incivility, highlighting workload as a mediating mechanism and distributive justice as a moderating force. By focusing on the higher education context, the study addresses a significant gap, providing a nuanced understanding of how leadership dynamics and perceptions of fairness jointly influence patterns of incivility through a mediated moderation framework.

Patient safety has become a global health priority, closely linked to the quality of medical services and the legal framework governing healthcare systems. This study aims to juridically and comparatively examine the regulatory frameworks of patient safety across various jurisdictions and analyze the contrasting approaches between developed and developing countries. Using a qualitative method with a literature review approach, data were collected from scientific journals, international health organizations such as the World Health Organization, government regulations, and previous empirical studies. The findings indicate that developed nations have implemented more structured patient safety regulations, characterized by mandatory, privileged incident reporting systems and legal protection for healthcare professionals (whistleblowers). In stark contrast, developing countries, including Indonesia, face persistent challenges related to limited resources, weak legal enforcement, and a prevalent blame culture that hinders open reporting. The comparative analysis highlights the critical need for legal reform in Indonesia to strengthen patient safety regulations, particularly through the revision of the hospital law, the integration of telemedicine into the legal framework, and the establishment of a transparent, protected reporting system. Ultimately, strengthening legal frameworks is essential to ensure that patient safety becomes a fundamental, enforceable, and systemic element of health systems worldwide.

ABSTRACT In this editorial, we examine how alternative forms of work organization (AFWOs) are both driving and being shaped by the ethical foundations underpinning them. Recently, scholars of organization and management studies have highlighted AFWOs as a response to broader societal challenges—digitalization, sustainability, and workplace democratization—and as an arena of intense experimentation in spatiotemporal flexibility and participatory management. Despite their growing adoption, AFWOs remain underexamined from a business ethics perspective, leaving open crucial questions about fairness, autonomy, empowerment, and the subjective experiences of workers—particularly in hybrid settings. Against this backdrop, in this special issue, we aim to clarify how and why business ethics matters in the context of AFWOs. The contributing authors pursue this aim by mobilizing diverse ethical frameworks to investigate the following key questions: How can AFWOs be grounded in a robust business ethics logic? What philosophical foundations can guide new organizational experiments? How might ethical inquiry illuminate the aspirations, tensions, and practical consequences of work environments characterized by flexibility, shared responsibility, and digital mediation? Collectively, the contributing authors advance a richer understanding of AFWOs by integrating theoretical reflection with empirical insights and foregrounding the ethical stakes of reimagining how work is organized today.

As hybrid and remote work become the new normal, how employees express their voice sharing ideas, concerns, or feedback has become both more important and more complicated. This paper explores how employee voice operates in digitally mediated workplaces, particularly within private higher education institutions. Using a qualitative approach, we analyzed organizational documents, HR policies, and sector reports to identify common challenges and patterns. While digital platforms have opened up new channels for communication, many employees still face barriers like unclear feedback processes, limited psychological safety, and inconsistent managerial engagement. The study draws on Social Exchange Theory to explain how trust, reciprocity, and recognition shape whether employees feel safe to speak up. Beyond identifying these barriers, the paper offers practical strategies for organizations looking to foster more inclusive and responsive communication. We suggest that digital tools alone aren’t enough—organizations must actively build cultures of openness and trust. To deepen understanding, future research should consider combining qualitative and quantitative methods, engaging directly with employees through surveys or interviews. Case studies of organizations that have successfully created space for employee voice could also provide valuable insights. Exploring other theoretical perspectives alongside Social Exchange Theory may offer a broader understanding of how voice functions in complex, hybrid work settings.