Introduction: A Queensland project team secured grant funding to pilot Project ECHO ® , a telementor ing model, to drive vertical and horizontal integration across paediatric, education and primary care services. This study sought to understand what influenced healthcare executives' decision-making pro cesses to organisationally commit to and financially invest in the pilot proposal within an organisational context. Theory and Methods: A phenomenological approach methodology was adopted to investigate healthcare executives' conscious decision-making processes. Semi-structured interviews with key stakeholders were conducted alongside project documentation analyses to create a thematic framework. Results: The qualitative thematic analysis identified five key themes that influenced the decision-making processes of healthcare executives to invest in Project ECHO ® as an integrated care pilot. The themes were: (i) personal experiences, (ii) benefits, (iii) risks, (iv) partnerships, and (v) timing. Executives' reflec tions explored how their decision-making processes considered the intrapreneurial project team as an indicator of future sustainability. Discussion: Findings highlighted healthcare intrapreneurs' drive to foster more integrated and peoplecentred approaches to care. Intrapreneurial aims of financial sustainability, ongoing improvement and scalability of the proposal positively influenced investment confidence. Conclusion: Intrapreneurial champions must provide a compelling narrative to convince executive decisionmakers that benefits will outweigh risks, that integration is achievable through strengthened partnerships as well as future sustainability beyond the pilot phase.

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