Quality work in long-term care: the role of first-line leaders.
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.
Kjøs
Bente Ødegård
BØ
Centre for Care Research, Gjøvik University College, PO Box 191, 2802 Gjøvik, Norway. bente@kjoes.com
Botten
Grete
G
Gjevjon
Edith Roth
ER
Romøren
Tor Inge
TI
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