Participant in Michigan Health and Hospital Association Keystone ICU Collaborative utilizing evidence-based guidelines to reduce risk and improve clinical outcomes including prevention of ventilator associated pneumonia, central line associated bacteremia, stress ulcer prevention, early weaning from ventilators, use of daily multidisciplinary rounds and goal setting for patient outcomes, institution of an enhanced culture of safety within the ICU, and development of additional protocols to manage other elements of care such as tight glucose controls.