APACHE 1978-2001: The Development of a Quality Assurance System Based on Prognosis

The development of APACHE (Acute Physiology and Chronic Health Evaluation) began on a Saturday in late June 1978 when I walked into the intensive care unit (ICU) of George Washington University Hospital in Washington, DC. I had come to Washington in 1972 and, with the exception of a year spent working in the former Soviet Union, had completed all of my internal medicine and critical care training in DC. This Saturday morning, however, was unique. It was my first as an attending physician, the last day of fellowship training being the previous day.