Quality Management in Long-Term Care.

Quality management (QM) is not just a recent strategy for management tasks such as resource management, personnel management, marketing management, risk management, knowledge management or innovation management, but it has become part of a quality movement. It is currently a firm element of scientific and public discussion on quality standards and a widely accepted requirement in the provision of social and health care services. For example, Total Quality Management (TQM) has become a comprehensive management philosophy, and an approach to management encompassing all tasks within a single framework. Although the concepts and strategies of TQM are proliferating, the discussion of central concepts of quality is still proceeding without a general agreement of terms and ideas, any agreed theoretical framework or consistent body of empirical findings. The TQM approach has been developed in the manufacturing industry, transformed for use with commercial services and has in the last 10 or 15 years become pervasive within public administrations and the health care and social services (Evers, Haverinen, Leichsenring, & Wistow, 1997; Görres, 1999; Øvretveit, 1998; Peterander & Speck, 2004). The movement has generated institutions and organisations on national and international levels that define quality for different realms of production, develop systematic standards, strategies and methods for quality development and certify their successful implementation. The certification of QM procedures can also be utilised in the competition in the marketplace for consumers. Quality becomes itself a product (certification) and a sales pitch, but at the same time the independently attested quality of products and service also provides consumer protection, since the consumer often has to rely on evaluations that he or she is not in a position to make himself or herself. Clearly, not all producers compete in the marketplace with similar levels of quality; it may be only the best quality for a given low price. Therefore, it is important to keep in mind that QM does not necessarily strive for the highest quality, but for a quality standard for given costs or prices. Moreover, since quality has a price, clients may have preferences for certain levels of quality, considering the trade-off between care outcomes and other consumption alternatives (Cangialose, Cary, Hoffmann, & Ballard, 1977). [ABSTRACT FROM AUTHOR]