Training will be multifaceted and will include all clinicians (physicians, nurses, clinical pharmacists and physicians-in-training) involved in the sedation management of intubated mechanically-ventilated patients. A multidisciplinary, cooperative approach is necessary to assure compliance and successful implementation of protocols. Training material will include discipline-specific lectures, informal discussions, video on sedation and opioid withdrawal scoring, bedside booklets, and physician order sheets. The research team will develop the supporting materials. Physician training will focus on sedation and opioid withdrawal scoring, identifying the patient's trajectory of illness, collaborating with nursing in prescribing the daily sedation goal, and completion of the standardized order template. Nursing content will likewise focus on sedation and opioid withdrawal scoring, trajectory analysis and collaboration, but also will include practical support on the daily "wake-up" test and titration of sedatives. Prior to the intervention phase, all physicians, physician-in-training, unit-based clinical pharmacist, charge nurses and full-time nursing staff will be required to document their understanding of the intervention by completion of a discipline-specific scenario-based self-assessment evaluation. Respiratory therapists will also require refresher instruction on extubation readiness testing and general information about sedation assessment and sedation algorithm.