Quality indicators in intensive care medicine : Background and practical use

Quality indicators are used in medicine to indirectly reflect quality via key figures. Intensive care medicine, in particular, contains a large number of standard processes for which quality monitoring is a suitable solution. The indicators used in quality assurance have advantages and disadvantages. The evaluation of fundamental aspects of the use of indicators in intensive care medicine can be illustrated by means of different types of indicators. A comparison of different indicators-the intensive care quality indicators of the DIVI (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin [German interdisciplinary association for intensive care and emergency medicine]) and a selection of international indicators-shows possible benefits of indicators, but also their limits in applicability and meaningfulness. The comparison also takes into account the possible applicability for individual institutions. There is no gold standard for the development of quality indicators. Nevertheless, methodological progress has been made in this area in recent years. Since the use of indicators has so far been unable to demonstrate any scientifically verifiable benefit for patient outcome, this aspect will have to come into the focus regarding development and application in the future. In addition, topics for the development of key figures are mentioned, which above all must be oriented more strongly towards the long-term well-being of patients.