Adapting practices that are described in the literature or used effectively in other critical care units provides an opportunity to improve the quality of critical care and reduce costs. Described in the literature are different techniques for the gradual withdrawal of mechanical ventilator support from patients during weaning from the ventilator. Phoebe Putney Memorial Hospital in Albany, GA used a systematic approach to adapt these techniques to improve the weaning process. This resulted in a reduction in the number of days patients were on a ventilator and a reduction in the ICU length of stay for patients with acute respiratory failure requiring mechanical ventilation.