The impact of elderly care competence and quality improvement programme in four Swedish municipalities

Abstract

During a number of years Swedish municipalities have work with improvment of competence and long-term quality in elderly care. The overall aim of the present study was to compare different learning activities (workplace improvement and/or courses), and to relate these activities to learning climate, learning strategies, and perception of care quality. In addition, the effect of organisational changes was tested. Four Swedish municipalities were selected and 219 nursing assistants filled in a questionnaire (response rate, 58%). Documentation of the learning activities was collected. A two-way multivariate analysis of variance was computed to answer the research questions. The results showed that there was a main effect for learning activities and organisational change on learning climate and learning strategies, but not on the perception of care quality. A combination of courses and workplace improvement practices yielded better results compared with only one of these activities, and organisational changes had a negative effect. The results suggest that the workplace should not only be regarded as an area for non-formal training but should also be included as a part of a training programme. Organisational changes should be avoided during the programme, otherwise the expected effects of the time and effort invested may be wasted.