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This article aims to explore coronary care unit (CCU) extubation structures, processes and outcomes. There were 13 unplanned-extubation cases (UE) among 251 intubated patients (5.2 per cent) in a cardiologist-led CCU in 2008. Seven did not require re-intubation, implying possible earlier extubation. A quality improvement project was undertaken with a goal to eliminate CCU UE within 12 months.

Using the clinical practice improvement (CPI) method, the most significant root causes were missing sedation/analgesia protocol, no ventilator weaning protocol and absent respiratory therapist during the CCU morning rounds. Non-physician directed sedation/analgesia and ventilation weaning protocols were created and put on trial in Plan-Do-Study-Act cycles before formal implementation. Arrangements were made to allocate a respiratory therapist to the CCU daily for morning rounds.

For 12 months after fully implementing the interventions, UE incidence dropped from 5.2 per cent to 0.9 per cent (p=0.006). There were no adverse outcomes, re-intubation and/or readmission to CCU within 48 hours.

Through a multi-disciplinary CPI approach, adopting non-physician directed protocols has successfully streamlined and improved airway management in mechanically ventilated patients in a cardiologist-led CCU.

There is little published data on improving intubated patient care in cardiologist-led CCUs. Previous studies centered on intensive care units managed by critical care specialists.

The purpose of this paper is to examine the process of information communication technology (ICT) reform in a government school in Singapore. The focus is on the distributed leadership actions performed by various individuals, and how the multiple leaders and their leadership practices interacted with one another.

A naturalistic inquiry approach was adopted, involving the case study of a school in the process of implementing an instructional reform involving the use of ICT.

It was found that distributed leadership for ICT implementation requires a combination of transformational leadership and instructional leadership to develop teachers’ capacity to enhance their instruction with ICT, emotional leadership to support teachers’ effort to change, and strategic management of resources to sustain teachers’ change efforts. Transformational leadership is performed mainly by senior management (SM). Instructional leadership is performed mainly by middle management (MM). Both senior and middle management provided emotional leadership and strategic resource management. In addition, SM provided second‐order changes leadership, while MM provided first‐order changes leadership.

The paper rectifies the current disproportionate focus on the role of the Principal by uncovering the leadership actions performed by other school members, and how these leadership actions are interrelated. In particular, the paper provides insight into how leadership was distributed in a school reform involving the use of ICT for instruction.

The purpose of this paper is to assess leadership learning in a principalship development programme.

This case study adopted Popper's three worlds as an analytical framework to assess leadership learning in a principalship development programme. The unit of assessment of learning is knowledge – more specifically subjective and objective knowledge. The study involved participants in a principalship development programme called the Leaders in Education Programme (LEP). The LEP is designed and implemented by the National Institute of Education, Singapore with partnership from the Ministry of Education, Singapore. Since its inception in 2001, the LEP has developed more than 300 school leaders in Singapore schools.

Through the analyses linking the concepts of complexity theory and Popper's three worlds, valuable insights were gained into how participants developed practical knowledge in leadership and management.

The outcome of the analyses has implications for leadership programme design and for leadership development in countries with similar challenges to prepare a new type of school leaders for the 21st century.

The purpose of this paper is to present a review of empirical studies on principal leadership in Singapore. It seeks to provide a general picture of Singapore principals’ leadership qualities, styles, and roles.

This is a systematic review of empirical studies, using a “bounded” approach with a focus on the main findings of the reviewed studies. In all, 36 studies were selected for the interview. The findings of these studies were open coded, synthesized, and clustered into different themes.

The review revealed several qualities, characteristics, styles, and enacted roles of Singapore principals. While there are similarities between Singapore principals and principals elsewhere in the world, the review brought out some features unique to Singapore principals.

This review contributes to the growing literature in comparative research on principals’ leadership and their enacted roles, and concurrently functions as a guide for further research on school leadership in Singapore.

When entrepreneurs create new ventures, they struggle with making consequential decisions under severe restrictions such as tight deadlines, limited resources, and lack of information. Making challenging decisions inherently requires creativity as entrepreneurs improvise and work around the limitations they face. Under these conditions, entrepreneurs resort to their heuristics and biases instead of rational decision models. Entrepreneurs employ – sometimes for better and sometimes for worse – a myriad of rule-setting heuristics and experience-based biases to navigate the difficult path between novelty and utility. In this chapter, the authors answer Shepherd, Williams, and Patzelt’s (2015) call for research into how entrepreneurs leverage heuristics and biases in decision-making and the benefits they gain as a result. The authors explore how entrepreneurs introduce heuristics and biases at different stages of their decision-making process using a qualitative study of 21 new ventures. The results attest to entrepreneurs’ ingenuity and creativity in managing complexity, ambiguity, and uncertainty.

In recent times, there has been some disquiet within certain sectors of the Singapore business community over the role of auditors in detecting corporate fraud. The cause of this concern can perhaps be attributed partly to the Barings collapse in February 1995 and the subsequent suggestions that the auditors of the Barings subsidiary in Singapore, Barings Futures Singapore Pte Ltd (BFS), may have been negligent in their audit work. More recently, in mid‐1996, a substantial locally listed company, Amcol Holdings Ltd (Amcol), was placed under judicial management amid rumours alleging possible misdeeds by senior executives and directors. The Amcol saga has, once again, focused some attention on the role of auditors and their duty to detect fraud in company accounts.

Unlike other populations, entrepreneurs may be unable to fully escape from job-related stress due to their financial and/or psychological connection to their ventures. The authors argue that stress is a universal, intangible variable that profoundly influences the entrepreneurial process. In the present review, the authors critically synthesize past literature to evaluate the substantive body of research on stress in entrepreneurship and assess the impact of stress on individuals’ well-being. The authors find that entrepreneurial stress stems from role conflict or overload, issues related to business operations, and concerns from life outside the venture. Further, stress may result in changes to personal satisfaction and psychological well-being, contingent upon an individual’s stress tolerance, coping strategies, or recovery practices. The entrepreneurial process, from creation to exit, is comprised of several transition periods, all of which are uniquely stressful. The authors explore the implications of our findings by discussing stressors that may manifest during each stage of the entrepreneurial process. Therefore, the authors respond to calls for more dynamic investigation of entrepreneurial stress while also highlighting the need for more research into stressors associated with specific entrepreneurial activities.