4. Management and Leadership
Innovation and progress regarding linking mechanisms within a comprehensive LTC system as well as between LTC and health and social care require sophisticated and innovative approaches in management and leadership, such as organisational development, human resource management and inter-organisational relations. There should also be a focus on quality development, the integration of older peoples’ and informal carers’ perspectives and of preventive and rehabilitative orientations.
4.1 Management and leadership competence and skills
Management approaches are needed to develop and maintain management and leadership competence and skills. Leadership expertise within LTC is essential for innovation and organisational and professional development. Examples must describe possible approaches including at least one of the following key issues:
- Foster leadership and management using appropriate training
- Establish management and leadership competences in organisations through mentorship, secondment and shadowing
- Establish leadership competencies regarding the management of networks
4.2 Quality assurance at workforce level
LTC staff need to be comprehensively trained, qualified and supported, so that specific functions and tasks can be fulfilled by designated people, teams, groups or partners (departments) with different roles, responsibilities, expertise and competences. Examples must include at least one of the following key issues:
- Training of professionals in interdisciplinary/interprofessional working
- Enabling interprofessional knowledge transfer
- Fostering diversity-sensitive knowledge and attitudes of staff, promote and make use of multi-ethnical teams
- Shaping job profiles, fostering and mutual understanding of comprehensive pathways
- Establishing competence regarding preventive and rehabilitative LTC
- Establishing competence and providing capacity for supporting and negotiating with older people and/or informal carers at their level
4.3 Contractual or pre-contractual bases of pathway links
Those contractual or pre-contractual instruments that enable functions to link together should be identified and examples include at least one of the following key issues:
- Using contracts or agreements to enable and sustain processes between services and/or organisations
- Contracts or agreements that link between services professionally and managerially
- Contracts or agreements that specify funding across services
4.4 Administrative support at interfaces
Administrative support is vital to ease the professional burden of bureaucracy within and between services. Examples must describe at least one of the following key issues, i.e.
- How organisations foster enabling administrative patterns as well as processes between services or organisations, making administrative systems compatible, reducing administrative burden
4.5 Ensuring relationships with stakeholders
Relations with older people and informal carers with other agencies in and outside of LTC need to be facilitated. Examples describe at least one of the following approaches (key issues) that:
- Enable participation of older people and carers’ representatives in shaping pathways and appropriate linkages
- Ensure conditions for older people's and carers’ shared decision-making
- Mobilise volunteers’ organisations, and ensure their participation
- Consider socio-economic, socio-cultural and gender differences of older people and carers
4.6 Quality management
Quality management should play an integral role within and between LTC to ensure an improvement in processes, structures and outcomes of care through management cycles. These include defining goals, planning and organising services to meet objectives, evaluating results and implementing changes. Quality management techniques can include, for example, reflective and reflexive quality circles with staff, reviewing care pathways, etc. Examples must consider at least one of the following key issues:
- Approaches for promoting and facilitating the quality of mechanisms in relation to linkage, networking, coordination or integration of agencies and organisations
- Approaches to ensure diversity-suitable structures and processes
- Approaches to ensure high quality structures and processes involving informal carers
- Approaches to shape preventive and rehabilitative structures and processes
- Approaches focusing on quality of structures, processes and results of LTC providers
- Approaches to measure and consider user satisfaction
