The interest in quality management in long-term care has been rapidly escalating. This movement to assess and improve quality parallels the effort carried out by hospital management in the past 10 years. The methodological concerns of the 2 areas are similar. This essay identifies 10 issues to which quality management leaders should pay attention as they begin to expand the capability of addressing quality in long-term care: client-centered performance versus whole-organization performance; standardization of methods and instruments; reliability; and validity, multimethod thinking, the meaning of data, comparability of data across organizations, cost barriers, feedback mechanisms, management use of quality data, and public control of data.
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