[The (non)sense of certification in intensive care medicine. The problem of the detection of suitable indicator systems].

Certification is a compulsory element of today's quality management. However, the instruments used for certification have mostly originally been developed for industrial purposes. Even with tried and tested adaptation to hospital structures, transferring these instruments to the medical environment implies partial negligence of outcome quality. This fact is due to the multidimensional structure of medical outcome quality, which cannot be reduced to only one indicator. This review describes the necessity to develop a specific indicator system, which is needed for an objective, reliable and valid system of certification for intensive care units. The second part of the review describes the current efforts which are being undertaken to develop such a certification system for German intensive care units. Until this new system has been validated, certification of intensive care units is of limited value for evaluating the quality of intensive care units in Germany.