Auditing respiratory intensive care units

Audits should be conducted in respiratory, intensive care units (ICU) as in all other ICU using patient-specific indicators to assess medical activity , and quality of care. However, other criteria, such as those developed by the SRLF ("Societe de Reanimation de Langue Francaise"), should also be use d. These criteria include the description of the patients previous health s tatus, prognosis of underlying diseases, the SAPS I or SAPS II severity sco re at admission, the omega or TISS therapeutic scores, and the PRN index of health care burden. Medial and administrative audits are conducted using diagnosis-related grou ps (DRG) and case mix classification. The DRGs are used to establish an agg regate index of activity (ISA points) which contribute to the complex mecha nism of budget allowance, Unfortunately, the French DRG case mix system doe s not provide an appropriate description of the costs of ICU stays. One of the special features of respiratory ICUs is related to patient flow, Patients are referred from a respiratory unit and discharged to a respirat ory unit or a respiratory rehabilitation center. Readmissions are frequent. Many patients are also admitted only for diagnosis or a respiratory proced ure requiring close surveillance. The SRLF criteria, which take into consid eration all of these features, should always be used for the evaluation of quality of care. The French Society of Lung Disease (SPLF) has proposed spe cific standards of quality for respiratory. ICU. We present here examples issuing for the ICU of the Hotel-Dieu Hospital in Paris. The results show that non-specific national indicators, in combinati on with other indicators specific for respiratory, ICU, provide appropriate audit data.