Guidelines for the provision of continuous analgesia, sedation, and neuromuscular blockade for critically ill patients requiring ventilator management. In this research the guidelines used a five-step process that included evaluation, analgesia, sedation, neuromuscular junction blockade, and dosage adjustment. A distinct end point for each class of agents was preserved. An academic detailing process was used to educate practitioners about the use of guidelines. Daily interventions were performed, and the prescribers were made aware, by direct and written communication, when their regimens varied from the suggested guidelines. The cost implications of such deviations were also brought to the attention of the prescribers.