Audit in Intensive Care

Abstract

The term “audit” is of Latin origin, and implied public examination of fact. In an industrial context it refers to verification of accounts and assessment of performance — cost effectiveness. Medical audit is more difficult to define because of the diversity of activities which represent health care, and audit therefore means different things to different people. There are however certain common elements of medical audit, which may be defined as “the systematic and public examination of factors which affect the delivery of good medical care”. This activity has always been a normal part of medical practice in the form of morbidity and mortality meetings, consensus conferences, and in the conduct of medical research. However, the definition raises questions which should themselves be the subject of research: what systems or standards are needed, and how can they be derived? Who should monitor results and have access to data? What factors should we measure and how? What do we mean by good medical care? Does the process of audit itself improve medical care? Simplistic phrases such as ‘value for money’ ignore the fact that health care systems are complex structures, even when the relationship between purchaser and provider is apparently clearly defined as in private practice.KeywordsCatastrophe TheoryPhysiological ReservePhysiological DisturbanceTherapeutic Intervention Scoring SystemIntensive Therapy UnitThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.