Healthcare professionals who practice while impaired by alcohol or drugs endanger the well-being of patients. In the workplace, the substance-impaired healthcare professional poses challenges for healthcare leaders who are responsible for the provision of safe patient care and safe work environments. The purpose of this multiple case study was to explore management strategies used by some healthcare organizational leaders to address the substance-impaired healthcare professional in the workplace. The conceptual framework for this study drew upon the legal and ethical concepts of due diligence. Data collection consisted of surveys of 40 managers and supervisors, and 3 senior leaders, semi structured interviews of executive leaders from one large hospital, and a review of company documents. A software program was used to organize the data for analysis. Five themes emerged that yielded 6 possible strategies that leaders could use to address the substance-impaired healthcare professional in the workplace: an affective healthcare business model, healthcare leader training, monitoring and surveillance systems, synergistic integration of work and life balance, and legal and ethical incident reporting. These research findings may contribute to positive organizational and social change by reducing the risk patients have from substance-impaired healthcare professionals.