{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:46:36Z","timestamp":1785818796347,"version":"3.56.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Population aging, a global crisis, has made private integrated medical - nursing facilities the primary providers for older adults care. However, the operational flaws of these facilities can potentially be addressed by the China - originated Wuli-Shili-Renli (WSR) methodology, which integrates physical resources, systematic management, and human factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective empirical before-after study was conducted to evaluate the implementation effect of the WSR framework on service quality management in one representative private integrated medical-nursing care institution in Taizhou between 2021 and 2024. All outcome indicators adopted in this study were longitudinal annual monitoring data independently collected from this single institution. Pre- and post-implementation data were compared to assess improvements in service quality across different dimensions of the WSR framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Statistically significant improvements were associated with WSR framework implementation: in Service Resources (Wuli), the 24-h on-duty rate of clinical doctors increased from 71.51% to 100% (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and the clinical nurse\u2013patient ratio improved from 15.14% to 21.58% (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); in Service Operation (Shili), psychological\/psychiatric support services were established (0 to 19 person-times,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), social organization participation increased by 300% (3 to 12 annual visits,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.035), and pipeline nursing staff nearly doubled (66 to 121,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); in Service Evaluation (Renli), the older population admission rate rose from 76.5% to 80.5% (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The WSR-based model was associated with optimized resource allocation, standardized processes, and improved evaluation, providing a scalable path for the high-quality development of geriatric care services amid population aging.<\/jats:p>\n                  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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Taizhou First People\u2019s Hospital","place":["Taizhou, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref1","year":"2024"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1178397","DOI":"10.3389\/fpubh.2023.1178397","article-title":"Editorial: long-term care for older people: a global perspective","volume":"11","author":"Hu","year":"2023","journal-title":"Front Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1111\/jgs.17710","article-title":"Stakeholders' views on priorities essential for establishing a supportive environment for clinical trials in nursing homes","volume":"70","author":"Delude","year":"2022","journal-title":"J Am Geriatr 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