ORIGINAL ARTICLES

Several factors influence the outcome of intensive care. It is intuitive that the severity of the patient’s presenting complaint and the pre-morbid condition will have a direct bearing on outcome.1 With the advances in medicine in general and intensive care in particular, many have argued that the rendering of quality intensive care is complex and can only be provided by medical and nursing experts in the field of intensive care.2,3 This approach is associated with improved patient outcomes and reduced cost of care.2 Decisions to initiate and withdraw care and to decide when a patient is fit for discharge requires a team approach involving a multidisciplinary group of health care professionals.4,5 The traditional approach to accomplishing these objectives has been via the adoption of a closed unit policy whereby a qualified intensivist leads a team with regard to protocols and guidelines for practice based on best available evidence.2 More recently it has been argued that this is an unrealistic goal even in the context of the relatively resource-rich USA health care system.6 In South Africa, there are no published data as to the current design and function of intensive care units (ICUs) and high care units (HCUs). In the face of limited resources it is crucial that decisions about the provision of health services be based on objective data.7 To this end, the Critical Care Society of Southern Africa (CCSSA) endorsed a study to evaluate the national distribution and functioning of ICUs in South Africa, and in particular the extent to which units in the country were ‘closed units’. Methodology During 2003-2004 an audit of ICU resources was undertaken. Approval to conduct the audit was obtained from the ethics committees of eight universities, the Department of National Health, the respective provincial health departments, th