Background:Senior Alert is a national quality register aimed at supporting a standardized, structured, and systematic preventive care process foradults aged 65 and over in the areas malnutrition, pressure ulcers, falls, problems with oral health and bladder dysfunction. Therefore, the quality register is particularly suitable for older adults with multimorbidity. Aim: The aim was to describe management practices that contributed to the sustained implementation of the quality register Senior Alert inmunicipal elderly care in Sweden. Methods: The design of this pilot study was descriptive and inductive. The sample of n = 12 included managers (n = 7) and care staff (n = 5) atseven municipal care homes for older adults in Sweden. The study was performed between April 2014 and June 2014 using twomethods: Individual interviews and nonparticipant unstructured observations. Data were analyzed using qualitative content analysis. Results: The analysis led to the following generic categories: leading teamwork, leading a preventive care process and leading a supportiveorganizational structure, and to one main category: management promoting learning and quality improvement. Conclusion: To be sustainable, Senior Alert implementations in municipal elderly care need management. Management, by leading teamwork, apreventive care process and a supportive organizational structure, is essential for achieving learning and quality improvement.