Clinicians using general guidelines or specific protocols commonly manage patient care. Acute, severe illness may require care in an intensive care unit (ICU), with many aspects of care managed concurrently. Variation of any aspect of care among patients, clinicians, ICUs and institutions is well known, and is due to a lack of standardization in clinical decision making and inability to implement detailed, patient responsive protocols. Automation of protocols for specific aspects of care using computing technology and medical informatics/knowledge engineering principles offers a consistent, systematic way to implement a protocol by prompting bedside clinicians in a timely manner, monitoring a patient's responses to therapeutic interventions, and monitoring the decision logic used. This paper describes a new generic system for design and implementation of computerized protocols.