Quality improvement in long-term care.

Creating a culture or environment in which total quality can take root is a challenging undertaking for most healthcare organizations. It requires staff at all levels to acquire new skills and problem-solving techniques and apply them in their daily work processes. Change is rarely easy, and it can become all the more difficult in facilities where budgets are strained, staff turnover is high, patients require special attention, and computer-assisted data collection and analysis is still in its infancy. Such is the situation in many long-term care facilities. Some forward-thinking state organizations, long-term care facilities, and national associations are developing strategies to address these issues. Admittedly, these efforts are still in their infancy, but early reports indicate that TQM has the potential to produce results in this field as it has in other healthcare settings.