Abstract
BackgroundLeadership has a vital role regarding quality of care in nursing homes. However, few studies have explored upper-level managers’ views on how to assure that residents receive high quality of care. Therefore, this study’s aim was to examine how managers of top-quality nursing homes define, develop and maintain high-quality of care.MethodWe used interpretive description, an inductive, qualitative approach. Our research included 13 semi-structured interviews with 19 managers. We analyzed their input using reflexive thematic analysis, which is an iterative approach.ResultsQuality development and maintenance are cyclic processes. Managers in high-performing nursing homes lead with high commitment towards a person-centred quality of care, creating appropriate working conditions and continuously co-creating a vision and the realization of quality of care together with employees.ConclusionsThis study confirms that, in high-performing nursing homes, a person-centered approach—one where both residents and employees are at the center—is essential for quality development and maintenance. The most effective managers exemplify “person centeredness”: they lead by example and promote quality-focused working conditions. Such strategies motivate employees to provide person-centered care. As this means focusing on residents’ needs, it results in high care quality.
Highlights
Improved standards of living and health care have dramatically increased life expectancy in many countries [1]
This study confirms that, in high-performing nursing homes, a person-centered approach—one where both residents and employees are at the center—is essential for quality development and maintenance
In Switzerland, Asante et al BMC Health Services Research (2021) 21:1090 even though the majority of nursing home residents rate their overall quality of care (92.8 %) and life (71.3 %) as good or very good [5, 10], recently developed Swiss quality indicators showed a wide range of quality between nursing homes [7]
Summary
Improved standards of living and health care have dramatically increased life expectancy in many countries [1]. The number of older adults receiving care in longterm-care facilities such as nursing homes is increasing [2] Helping this vulnerable group maintain their health and quality of life while retaining as much autonomy as possible demands high quality care in nursing homes [2]. Factors such as rising number of residents with complex care needs, high staff turnover rates leading to discontinuity of care, organizational process changes or scarce funding often make it difficult to provide nursing home residents safe, high-quality care [2,3,4,5]. This study’s aim was to examine how managers of top-quality nursing homes define, develop and maintain high-quality of care
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