Health professionals' experiences with participating in quality improvement in elderly care

Employee participation in quality improvement is essential for fostering engagement and job satisfaction and delivering high-quality care, as highlighted in the total quality management literature. However, how employee participation is facilitated during quality improvement processes within healthcare organizations remains largely unexplored. Previous studies have identified a research gap, highlighting the importance of examining this phenomenon from the perspective of health professionals. The purpose of this study was to gain a deeper understanding of how health professionals in nursing homes experience their participation in quality improvement. The underlying aim was to describe their involvement and how it can be strengthened, ultimately improving the quality of care.

This study is based on interviews with 17 health professionals from 2 nursing homes in a medium-sized Swedish municipality. Data were analysed with Reflexive Thematic Analysis.

The themes identified through the analysis are "experiences of barriers at the organizational level that limit participation in quality improvement" and "experiences of barriers in daily care that limit participation in quality improvement".

The themes address barriers to participation in quality improvement, reflecting an organizational structure that hinders participation and quality improvement. A quality culture, along with structured approaches to improve quality and foster employee participation is lacking. Implementing total quality management could help address the challenges faced by health professionals in these settings.