title: Quality work in long-term care: the role of first-line leaders.
abstract: OBJECTIVE
  To explore the first-line leaders' role in quality work in long-term care in Norway, in order to determine how that work is related to such success characteristics as leadership, staff, patients, performance, information and information technology.
  
  
  METHODS
  Cross-sectional telephone survey. The text was analysed using content analysis.
  
  
  METHODS
  Thirty-two Norwegian municipalities stratified according to region and population size.
  
  
  METHODS
  Sixty-four first-line leaders in nursing homes and home-based care. Main outcome measure The clinical microsystem approach is used as a framework by defining and designing measureable variables.
  
  
  RESULTS
  Thirty-six leaders described how they initiated and motivated employees to be active in quality work; the remaining leaders indicated that they played a passive role. The first-line leaders played a key role in implementing national quality policies and regulations. The quantity of other success characteristics was low.
  
  
  CONCLUSIONS
  The municipalities delegated the responsibility of implanting national policies to the first-line leaders. Missing were key quality success criteria such as macro- and meso-perspectives for the municipality as a whole and co-operation with other leaders in the organization and fostering of relevant learning. Quality work was fragmented rather than comprehensive and systematic.
authors.affiliation: Centre for Care Research, Gjøvik University College, PO Box 191, 2802 Gjøvik, Norway. bente@kjoes.com
authors.forename: Bente Ødegård
authors.initials: BØ
authors.lastname: Kjøs
authors.forename: Grete
authors.initials: G
authors.lastname: Botten
authors.forename: Edith Roth
authors.initials: ER
authors.lastname: Gjevjon
authors.forename: Tor Inge
authors.initials: TI
authors.lastname: Romøren
mesh_terms: D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006801:Humans; D007857:Leadership; D008134:Long-Term Care / Q000458:organization & administration*; D009042:Motivation; D009664:Norway; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires