Quality management in long-term care
WHO is supporting the development of long-term care systems grounded in strong and transparent quality management, which includes:
- the development and regular updating of quality standards (recommendations or statements for what constitutes good-quality care, enshrined in guidelines, legislation or other regulatory documents);
- quality measurement (operationalization of quality standards into measurable indicators that can be regularly collected and used to evaluate quality of care);
- quality assurance and monitoring (all activities and mechanisms that help to verify if care services comply with standards of care); and
- quality improvement (including all systematic approaches to enhance the quality of care delivery and all outcomes that are meaningful to care users and caregivers).
User engagement and a focus on user-reported outcomes (such as quality of life, satisfaction with care and perceived well-being) are the cornerstones of effective quality management in long-term care, as they ensure that services are responsive, effective and aligned with the needs, preferences and experiences of care users, caregivers and their communities.
To ensure well-being and quality of life in older age, long-term care systems must provide reliable access to high-quality care. Whether delivered in the user’s home, in community-based centres or in long-term care facilities, high-quality long-term care services are essential for promoting the well-being and dignity of older people with care needs, their caregivers and their communities in a safe and effective way.
Without strong quality management systems, long-term care services may fail to support the well-being and dignity of older people – and in some cases may even cause harm. Older people who rely on care are especially vulnerable to neglect and abuse when proper safeguards and quality controls are not in place.
As countries across the WHO European Region work to expand and improve their long-term care systems to meet growing demand, it is essential that this care is also safe, appropriate and respectful of people’s preferences. However, progress in developing comprehensive national quality frameworks remains inconsistent. Many countries are expanding community-based care faster than they are building the regulations and oversight needed to ensure its quality. This gap highlights the urgent need for clear standards, monitoring systems and accountability in all care settings – including facility-based, home-based and community-based care.
To ensure that improvements in access also result in better outcomes, countries must pair service expansion with efforts to strengthen quality management. This means shifting from a narrow focus on quality assurance towards a culture of continuous improvement that centres the needs of both care recipients and caregivers.
The WHO Regional Office for Europe is working closely with countries to improve quality management in long-term care and support ongoing improvement efforts. This includes:
- developing evidence-based guidance on standards and procedures for effective quality management systems;
- offering technical support to review existing frameworks, identify gaps and create tailored strategies for improvement; and
- facilitating opportunities for countries to share successful practices and innovative approaches through learning and knowledge exchange.
Through these initiatives, the WHO Regional Office for Europe helps countries to build resilient, person-centred long-term care systems that are equipped to meet the evolving needs of older people, caregivers and communities.
For more information, please contact euroltc@who.int.
