Quality assurance and utilization assessment: the major by-products of an ICU clinical information system

In 1985 we developed a method of automatically extracting indices of severity of illness and intensity of interventions from CIS charts daily. These indices, when combined with outcome measures such as length of stay and mortality, provide a powerful new tool for quality management in the ICU. In this paper we describe our ICU's severity adjusted survival rates as compared to internationally publish norms. In addition we provide a detailed analysis of glucose levels in our ICU, which suggests that glucose control in surgical ICU patients is more closely related to measured severity of illness than administration of intravenous alimentation per se. CIS extracted indices provide a new basis for continuous quality measurement and improvement in the ICU.