In just one year in the US alone, over 1.1 million discharges with a diagnosis of respiratory failure required mechanical ventilation, equating to a 10.5-day average length of stay. The patient safety risks of poor respiratory management, such as infection, failed planned extubations, and unplanned extubation, are common and increase organizational cost. The organizational challenge is complicated by the fact that respiratory management spans multiple settings, involves interdisciplinary team members, and necessitates reliable communication, coordination, and teamwork across the system. Many healthcare organizations have successfully implemented and sustained improvements, reducing death from poor respiratory management. This blueprint outlines the actionable steps organizations should take to successfully improve respiratory management outcomes.