Silence Among First-Line Managers in Eldercare and Their Continuous Improvement Work During Covid-19

Area of Science:

• Healthcare Management
• Organizational Psychology
• Public Administration

Background:

• The eldercare sector faced significant challenges during COVID-19, impacting daily operations and continuous improvement.
• First-line managers in public, hierarchical eldercare organizations play a vital role in facilitating learning but may encounter obstacles.
• Managerial silence, a prevalent issue, can impede effective operations and development within these settings.

Purpose of the Study:

• To investigate the prevalence and nature of silence among first-line managers in Swedish public eldercare.
• To identify the organizational conditions and supportive factors influencing this silence.
• To understand the implications of managerial silence for daily operations and continuous improvement initiatives.

Main Methods:

• A mixed-method study involving a questionnaire distributed to 189 first-line managers across 33 Swedish municipal eldercare organizations.
• Analysis included qualitative coding of organizational conditions, descriptive statistics, and stepwise regressions.
• Utilized instruments such as the Communication of Critical Issues at Work and Managerial Work.

Main Results:

• Quiescent (fear-based) and acquiescent (demotivation-based) silence were the most common forms observed.
• Strict hierarchical governance, lack of support, and feeling undervalued were key organizational factors contributing to silence.
• Managerial silence negatively impacted managerial work, particularly hindering continuous improvement efforts.

Conclusions:

• Managerial silence is detrimental to continuous improvement in eldercare, especially in organizations valuing organizational professionalism over individual input.
• Supportive leadership from superiors and management teams, fostering trust and occupational professionalism, can significantly decrease managerial silence.
• Improving supportive conditions is essential to mitigate silence and enhance continuous improvement in eldercare operations.