Thesis: Exploring the role of managers in quality and safety work in nursing homes and homecare services: A multiple case study
Johannessen's thesis explores the role of managers in quality and safety work in nursing homes and homecare services. The thesis designs, implements, and evaluates a leadership intervention in nursing homes and homecare services to support managers` quality and safety work. Terese Johannessen defended her thesis at the Faculty of Health Science (UiS) on the 8th of April 2022.
The study was designed as a two-phased longitudinal multiple case study consisting of design and pilot testing, and implementation and evaluation of the SAFE LEAD intervention. The intervention is based on a leadership guide and includes several workshops and learnings activities facilitated by researchers. Phase 1 included the design of the intervention with researchers, co-researchers, and managers from two nursing homes and one homecare services. The pilot test of the leadership intervention was conducted in one nursing home and one homecare service. Data collection consisted of focus group interviews and observation of managers. Phase 2 started by exploring the quality and safety challenges as perceived by managers and employees in two nursing homes and homecare services prior to participate in the leadership intervention. The study then continued with a longitudinal study of the implementation and evaluation of the leadership intervention and its influence on quality and safety work. Data collection included focus group interviews, observations, workshop and site visits with managers and employees.
The results describe all activities from development to evaluation of a leadership intervention and its influence on managers quality and safety improvement work in nursing homes and homecare services. The thesis shows how involvement of stakeholders, and the use of participatory approach was important for adaptions of a leadership guide to nursing homes and homecare contexts and a key finding is the need to tailor the intervention material to the context and to the needs, time constraints, language, and interest of managers. Managers and employees found that quality and safety challenges depended on several factors and implied trade-offs such as managers struggled with external change processes and budget cuts that affected a common understanding of and commitment to quality and safety improvement at managerial and staff level. The longitudinal insight in this thesis broadens the understanding of contextual impact of quality and safety work in nursing homes and homecare services. The thesis demonstrated the comprehensive work with translating knowledge into practise. The findings show that the leadership intervention created a place for reflection for managers and brought a more structured process to organisational quality and safety work.
Terese Johannessen (34) is born in Farsund. She is a nurse and holds a master’s degree in health sciences from the University of Stavanger from 2016. She is currently on maternity leave but holds a position as associate professor at the university of Agder.
Main supervisor:
Professor Siri Wiig, University of Stavanger, SHARE - Centre for Resilience in Healthcare
Co-supervisor:
Eline Ree, University of Stavanger
Roland Bal, Erasmus School of Health Policy & Management