Social tourism: a potential policy to reduce social exclusion?

Social tourism is often presented by charities and governmental organisations as a potential means to counter social exclusion. It has more specifically been linked to potential benefits such as improvements in family relations, a more pro-active attitude to life, an improvement in the academic performance of children etc. Even though this argument is often used when promoting social tourism, there is very little research evidence that supports these claims. This research concentrates on visitor-related social tourism for low-income groups, and the effects a social holiday can have on the daily lives of the families who are offered these holidays. The paper reports on qualitative two-stage research that has been conducted with participants of social holidays in the UK and their welfare agents. It will present findings as to how far holidays can assist with the integration of socially excluded, and this on different levels: family relations, parenting, pro-social attitudes, mental and physical health and community involvement are examples of categories used to measure change. Different types of holidays will also be compared to analyse the merits and limitations of each type (individual family holidays versus group holidays).

Organisational and systems factors impacting on patient safety in acute care organisations: lessons from four multi-site research studies

Background Patient safety is concerned with preventable harm in healthcare, a subject that became a focus for study in the UK in the late 1990s. How to improve patient safety, presented both a practical and a research challenge in the early 2000s, leading to the eleven publications presented in this thesis. Research question The overarching research question was: What are the key organisational and systems factors that impact on patient safety, and how can these best be researched? Methods Research was conducted in over 40 acute care organisations in the UK and Europe between 2006 and 2013. The approaches included surveys, interviews, documentary analysis and non-participant observation. Two studies were longitudinal. Results The findings reveal the nature and extent of poor systems reliability and its effect on patient safety; the factors underpinning cases of patient harm; the cultural issues impacting on safety and quality; and the importance of a common language for quality and safety across an organisation. Across the publications, nine key organisational and systems factors emerged as important for patient safety improvement. These include leadership stability; data infrastructure; measurement capability; standardisation of clinical systems; and creating an open and fair collective culture where poor safety is challenged. Conclusions and contribution to knowledge The research presented in the publications has provided a more complete understanding of the organisation and systems factors underpinning safer healthcare. Lessons are drawn to inform methods for future research, including: how to define success in patient safety improvement studies; how to take into account external influences during longitudinal studies; and how to confirm meaning in multi-language research. Finally, recommendations for future research include assessing the support required to maintain a patient safety focus during periods of major change or austerity; the skills needed by healthcare leaders; and the implications of poor data infrastructure.