Wuli-Shili-Renli methodology as a service quality management tool among private older adults care institutions in Taizhou, China: an empirical study

Background 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. Methods 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. Results 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% ( p < 0.001) and the clinical nurse–patient ratio improved from 15.14% to 21.58% ( p < 0.001); in Service Operation (Shili), psychological/psychiatric support services were established (0 to 19 person-times, p < 0.001), social organization participation increased by 300% (3 to 12 annual visits, p = 0.035), and pipeline nursing staff nearly doubled (66 to 121, p < 0.001); in Service Evaluation (Renli), the older population admission rate rose from 76.5% to 80.5% ( p < 0.001). Conclusion 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.