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OBJECTIVES: Improving patient safety by investigating sentinel events (SEs) is hampered by the focus on isolated events within hospitals and a narrow scope of traditional root cause analysis methods. We aimed to examine if performing cross-hospital aggregate analysis of SEs applying a novel generic analysis method (GAM) bearing a human factor perspective can enhance learning from SEs.METHODS: A retrospective cross-sectional review of SE reports from 28 Dutch general hospitals using the GAM to reanalyze events was performed. A qualitative approach was used to identify contributing factors and system issues. Findings were discussed with a patient safety expert panel. Descriptive statistics and measures of associations between domains were calculated.RESULTS: Sixty-nine SE reports were reviewed. Applying the GAM provided a more holistic SE analysis than a traditional method. Of the 405 identified contributing factors in all SEs, the majority was related to the persons involved (patients and professionals, n = 146 [36.2%]) and the organization (n = 121 [30%]). The most frequently recurring pattern was the combination of factors related to the persons involved, the technology used, the tasks of professionals, and organizational factors influencing the event. Cross-hospital aggregate GAM analysis of SEs helped to identify system issues and propose more system-oriented overarching recommendations.CONCLUSIONS: This study found that applying the GAM to analyze SEs across hospitals can help to improve learning from SEs and may result in proposing stronger recommendations. The method can support hospitals, working together in a network of hospitals, to jointly learn from SEs.

This Report provides both a summary and a review of the SmartCulTour LLs’ experiences. It moves from an assessment of the specific context dynamics, resources and values of the six destinations, and it spans processes, tools and methods therein adopted towards instilling a sustainable, critical thinking into key tourism stakeholders and shareholders, including actual and potential cultural tourists. Deliverable 6.5 comprises two distinct, though strictly interrelated components. The first component concerns the overall SmartCulTour Living Labs’ experience, and starts with an Introduction that provides a concise overview of the project’s journey within the demanding and inspiring realm of the LLs. The conclusive section of the first component is broad in scope, comprising Final Recommendations that are derived from the knowledge gained during the project, and the Conclusions, which draw upon the main transversal findings from the LLs’ processes and experiences, and seek to outline what future Lab Managers should know about participatory approaches to sustainable cultural tourism development. More specifically, the Final Recommendations target researchers and practitioners that plan either to establish new LLs, mainly in the context of – but not limited to – an EU-funded and multi-partner project, or to existing LLs that wish to improve their performance towards achieving medium- to long-term objectives of sustainable cultural tourism development. The Conclusion’s main outcome is that the SmartCulTour Living Labs (LLs) demonstrate the success of using such a tool for creating multi-stakeholder networks for sustainable cultural tourism development and planning, allowing for multiple perspectives and collective intelligence. Indeed, the process of collaboration and networking during the LLs was considered more important than fully achieving the initial objectives, as it led to improved cooperation and boosted the LL’s innovative co-creation potential. The use of tools and methods provided by Work Package 7 (WP7) enhanced participants’ engagement and local ownership, creating a safe environment for equal expression and reducing power imbalances. Different approaches were adopted for long-term sustainability, either by establishing physical venues for the LL or by integrating its legacy into existing networks and projects. UNESCO's capacity-building activities were highly valued since they addressed local skills gaps while promoting integrated cultural tourism management and sustainable development processes. Exchange visits among the LLs facilitated learning from international good practices, while offering opportunities for testing and validating the interventions co-created within LLs. Practice abstracts and videos were produced to provide practical information and inspiration for other destinations. It is concluded that the SmartCulTour LLs' experiences, tools, and findings have the potential for scalability and diffusion, linking theoretical and practical components to positively impact local communities. In addition, funding, stakeholder engagement, scalability and generalisability, regulatory barriers, knowledge sharing, and intellectual property were identified as common challenges for future Lab Managers. This General part is complemented by five Annexes, respectively presenting: The Template that was provided to the Lab Managers to support them in the drafting process of their respective LLs’ reports within D6.5 (Annex 13); An An overview of different EU funding schemes and their potential links with interventions identified and designed in the context of the SmartCulTour project, providing LLs’ participants and regional authorities with insights for potential afterlife funding strategies (Annex 15); The results of the SmartCulTour Living Labs’ evaluation conducted by Modul University (Vienna, Austria), whose main goal was to uncover factors contributing to success and value co-creation in the six different LLs, as well as to identify the challenges faced in and by the LLs in order to gain insights and provide guidance on what shall be improved for future LLs to ensure high-quality outcomes (Annex 16); and The Deliverable’s Reference list (Annex 17). The second component of the Deliverable consists of contributions from each Lab Manager, offering an overview of the six LLs’ experiences, namely: A brief summary of the LL’s workflow introduces each section, followed by an explanation of the main activities (compared to the original workplan outlined in D6.1, i.e. the Specific Terms of Reference for the SmartCulTour LLs), key LL participants, including related internal dynamics, as well as service-design methods and art-based tools used to improve stakeholders’ engagement and networking. A presentation of the results and impacts of each LL, including main challenges encountered throughout the process, and key goals achieved compared to the set objectives. A section reflecting on sustainability aspects and follow-up actions, both in terms of outcomes from the LLs’ experiences, and with a view at the afterlife strategy of the LLs themselves (where applicable) as entities that can be catalyst for sustainable change in cultural tourism. In addition, each Lab Manager proposes follow-up recommendations for the LL based on his/her specific knowledge of the context and its recognised and potential impact, identifying strategic axes to be potentially explored and leveraged in the future.

This interactive session showed partipants the powerful combination of artbased and service design methods in developing sustainable cultural tourism

The SmartCulTour Toolkit for cultural tourism policy development is Deliverable D7.3 of the SmartCulTour Horizon 2020 project and provides an overview of selected and tested arts-based and service design tools and methods for community-participation and co-creation through various stages of the development phase. The pdf version included here provides a static overview of various tools that could be considered by planners, policy makers and DMOs to support participatory development processes. An interactive version is provided at https://smartcultour.maglr.com/toolkit/smartcultour-toolkit The Toolkit includes the following tools: Tools for Discovery and Define stage: The Placemaking tool Q-Sort methodology Stakeholder mapping Persona development tool Customer journey mapping Participatory systems mapping Visitor flow mapping Dynamic House of Quality Tools for Development and Delivering stage: The SmartCulTour Game Benchmarking and Honeycomb mapping Multi-Method process flow Ideation washing machine Destination design roadmapping Strategic roadmap for cultural tourism change Policy round tables for cultural tourism change

The Training aid for implementing the SmartCulTour Toolkit was developed to guide and assist the usage of the different tools of SmartCulTour Toolkit (D7.3). Designing a sustainable cultural destination needs a set of tools, each with its own purpose with an instruction on why, when and how to use it in combination with other tools. To provide efficient and easy access to learn and use different tools, the Training aid was created as an online magazine. It provides 14 different tools, which are explained in a similar way. You can find this publication following this link: https://smartcultour.maglr.com/toolkit/smartcultour-toolkit or by browsing to the SmartCulTour website (www.smartcultour.eu), hovering over the tab "Tools" and selecting "SmartCulTour Toolkit".

Practice abstracts and videos are often envisioned within the multi-actor approach (MAA), which is typical of Horizon 2020 projects and brings together a range of different stakeholders, spanning people from science, practice, or anyone who can help tackle the objectives of the project. All experience and knowledge are therefore taken into account and the partners co-create results together, to address real-life problems through innovative and intersectoral approaches. In this perspective, practice abstracts and videos are intended to communicate a short summary of information or recommendations that have been observed or developed during the lifetime of a project, as well as to provide good practices as role models for replication in other contexts. As part of SmartCulTour’s WP6, Task 6.4 included the production of practice abstracts and the recording of relevant videos on interventions that were identified in the SmartCulTour Labs for their relevance as interesting and insightful cultural tourism interventions, and were either taking place in the region and supported by the Lab’s activities, implemented within the SmartCulTour project or co-designed by Labs’ stakeholders for future implementation. These are innovative/promising direct and indirect interventions, or a combination thereof, for the sustainable development of cultural tourism, with potential/possible impacts on sustainability and resilience of the destination. Accordingly, each Lab Manager was requested to produce one or more practice abstracts and videos, by providing practical information and outlining the main objectives and findings related to the selected intervention(s). Deliverable 6.2 gathers the texts of the practice abstracts produced by each of the six SmartCulTour Living Labs, along with the links to access the videos on the SmartCulTour website and YouTube channel. Two typologies of videos were produced: presentation video(s) of each Living Lab, and videos showcasing the intervention(s) selected, designed and/or implemented by each of them. These materials were developed primarily with a communication purpose to facilitate information sharing with those who can directly apply the findings, namely cultural tourism practitioners, policy-makers, etc. Local stakeholders were also involved in the production of the practice videos, so as to let them shape the storytelling for their own destination, while leveraging local ownership of the interventions. In order to boost their dissemination and outreach, the practice abstracts are available both in English and in the Living Lab’s local language, while the videos are subtitled in English or in the local language, as needed.

The Strategic roadmap for the cultural tourism change tool was developed for the SmartCulTour project, and it is one of the WP7 deliverables. Since the tool is its own deliverable, it is presented separately in this document. The Strategy roadmap is part of the D7.3 SmartCulTour toolkit, where the tool is presented as part of the design process and sustainable cultural tourism development. Refer to the D7.3 SmartCulTour Toolkit and D7.4 Training aid for further information. However, this document allows the tool to be used as a separate action, for example, in the case when destination do not want to follow a very community-driven development approach but can still follow the strategic roadmap from a top-down planning approach. The document will follow through with the purpose and preparations for the workshop where the Strategy roadmap is used. At the end of the document, the templates of the Strategic roadmap for cultural tourism change is attached. When using the templates, print them A3 size or bigger.

Building resilience in the face of threats to communities is a requirement for communities to be sustainable and recover. The role of people-to-people experiences, between host and guests/tourists, can be a helpful tool in building resilience. This paper aims at creating a process for designing the required experiencescapes which allows individuals in communities to engage with each other in valuable people-to-people experiences. Current projects provide information on how to use a set of design tools, and how the resulting design process could look like. With this paper we hope to collect input for the development and improvement of these tools and processes.