title: Senior staff perspectives of a quality indicator program in public sector residential aged care services: a qualitative cross-sectional study in Victoria, Australia.
abstract: OBJECTIVE
  The aims of the present study were to describe the views of senior clinical and executive staff employed in public sector residential aged care services (RACS) about the benefits and limitations of using quality indicators (QIs) for improving care, and to identify any barriers or enablers to implementing the QI program.
  
  
  METHODS
  A cross-sectional qualitative study using semistructured interviews and direct observation of key informants involved in the QI program was performed across 20 public sector RACS in Victoria, Australia. Participants included senior clinical, executive and front-line staff at the RACS. The main outcome measures were perceived benefits and the enablers or barriers to the implementation of a QI program.
  
  
  RESULTS
  Most senior clinical and executive staff respondents reported substantive benefits to using the QIs and the QI program. A limited number of staff believed that the QI program failed to improve the quality of care and that the resource requirements outweighed the benefits of the program, resulting in disaffected staff.
  
  
  CONCLUSIONS
  The QIs and QI program acted as a foundation for improving standards of care when used at the front line or point of care. Senior executive engagement in the QI program was vital to successful implementation.
authors.affiliation: National University of Ireland, Galway, Irish Centre for Patient Safety, University Road, Galway, Ireland. Email.
authors.forename: Liam M
authors.initials: LM
authors.lastname: Chadwick
authors.affiliation: Ballarat Health Services, Ballarat, Vic. 3350, Australia. Email.
authors.forename: Aleece
authors.initials: A
authors.lastname: MacPhail
authors.affiliation: Ballarat Health Services, Ballarat, Vic. 3350, Australia. Email.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Ibrahim
authors.affiliation: Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic. 3086, Australia. Email.
authors.forename: Linda
authors.initials: L
authors.lastname: McAuliffe
authors.affiliation: Royal District Nursing Service Research Institute, Melbourne, Vic. 3182, Australia. Email.
authors.forename: Susan
authors.initials: S
authors.lastname: Koch
authors.affiliation: Australian Institute for Primary Care and Ageing, La Trobe University, Melbourne, Vic. 3086, Australia. Email.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Wells
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D006801:Humans; D007407:Interviews as Topic; D036301:Qualitative Research; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D012112:Residential Facilities / Q000592:standards; D014739:Victoria