This chapter examines the effects of talent development and knowledge management on executive decision-making with change management practices mediating in the pharmaceutical and medical technology (MedTech) industries. The results indicate that both talent development and knowledge management exert important and positive direct impacts on the quality of executive decision-making. In addition, change management practices were a significant partial mediator in these relationships. This suggests that systematic processes for planning, communications, and development of implementing change are important mechanisms by which investments in talent and knowledge systems translate into superior intentions at the executive level. The chapter ends with the realisation that strategic decision-making needs to be supported with an integrated approach. These insights pave a way to improve strategic agility and competitive resilience to a high-stakes industry.