Perceptions and experiences of risk management by managers of residential aged care facilities: a qualitative study from Hunan Province, China

BACKGROUND: With adverse events and injuries recurring in residential aged care facilities (RACFs), older adults’ safety in residential age care settings has attracted extensive attention from governments, researchers, and healthcare providers. Risk management is of utmost importance in reducing risks and improving the quality of care for older adults in long-term care. Although previous studies have made great efforts to explore risk management methods and technologies in RACFs, little is known about how managers identify and respond to risks in practice. PURPOSE: This qualitative study aimed to elucidate the perceptions and experiences of managers involved in risk management in RACFs in China. PARTICIPANTS AND METHODS: This study used a phenomenological research design. We conducted semi-structured interviews with 13 managers across 11 RACFs in Changsha City, Hunan Province, China. Data were analysed using Colaizzi’s seven steps and NVivo 12 plus software. RESULTS: “Facilitation of an error-free culture” emerged as a central theme of managers’ perceptions of risk management. Four sub-themes were revealed, namely “creating an age-friendly physical environment,” “paying close attention to frail older adults,” “improving the competence of nursing staff,” and “building effective management programs.” CONCLUSION: Facilitation of an error-free culture was of prime importance in risk management. Managers’ experiences can help RACFs to better manage risks, as well as provide new perspectives and approaches for RACFs to improve the quality and outcomes of care. This study developed initiatives for improving resident safety in RACFs and may foster interest in the developing these initiatives.