Transitions In Regional Science – Regions In Transitions: Regional Research In Central Europe

There are no exact boundaries of what constitutes Central Europe, but it is nevertheless very evident as a zone of interloping forces stretching across Europe. The result has been negotiated, conflictual and contested processes defining an essentially virtual, discursive, yet also actually existing, space of ‘Central Europe’. Yet, and this is the particular message of this collection of essays, ‘transition’ has not merely been a process ‘on the ground’ as object of investigation and discussion, but has also affected the observers, especially academic commentators and analysts – both within Central Europe, but also outside. This includes a growing interaction between discussions and analyses ‘inside’ and ‘outside’ Central Europe on the phenomenon of ‘transition’. The result has been mutual learning processes and changes of ways of looking at things and interpreting them. The book is divided into two parts, roughly reflecting the two key research questions.The first part (A) is devoted to transitions in regional science. Part B focuses on changes in variety of territorial structures and developmentissues caused by Central-European transitions and which are resulting in differential pathways of regional development in the region.

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.