For decades, cluster initiatives and funding programmes have been used as instruments of industrial and innovation policy—addressing system failures by strengthening linkages among actors, fostering innovation, and developing more effective innovation systems. More recently, a growing segment of these initiatives are also focused on driving system-level transformation and contributing to broader societal benefits. This segment is characterized by larger-scale and longer-term strategic efforts involving a variety of stakeholders across different parts of society, aimed at contributing to addressing societal challenges. These characteristics are shared with the emerging frame of transformative innovation policy, which highlights the importance of embedded practices of learning and reflexivity to enable continuous monitoring of progress and inform and adapt the direction of systemic change processes—requiring new approaches to governance and evaluation. Despite deep experience with implementing cluster programmes and other systemic innovation policy instruments, practitioners still struggle with monitoring and evaluation. Current approaches focus on evidencing strengthened innovation (and economic effects) on the level of firms and research actors, and fail to capture contributions on the level of the broader system. This article presents an evolving approach for tracking system transformation in clusters and collaborative innovation initiatives. Through an interactive, co-development process with initiatives in the Swedish Vinnväxt programme, this research proposes a definition and set of system effect categories for cluster initiatives. It tests a participatory approach for tracking their contribution to system-level change over time, providing an initial case on which to build and apply in other transformative innovation programmes.
BackgroundBreathlessness is prevalent in severe disease and consists of different dimensions that can be measured using the Multidimensional Dyspnea Profile (MDP) and Dyspnea-12 (D-12). We aimed to evaluate the feasibility of MDP and D-12 over telephone interviews in oxygen-dependent patients, compared with other patient-reported outcomes (modified Medical Research Council (mMRC) and Chronic Obstructive Pulmonary Disease Assessment Test (CAT)) and with completion by hand.MethodsCross-sectional, telephone study of 50 patients with home oxygen therapy. Feasibility was assessed as completion time (self-reported by patients and measured), difficulty (self-reported) and help required to complete the instruments (staff). Completion time was compared with mMRC and CAT, and feasibility was compared with completion by hand in cardiopulmonary outpatients (n=182). Feasibility by age and gender was analysed using logistic regression.ResultsOf 136 patients approached, 50 (37%) participated (mean age: 72±10 years, 66% women). Completion times (in minutes) were relatively short for MDP (self-reported 6 (IQR 5–10), measured 8 (IQR 6–10)) and D-12 (self-reported 5 (IQR 3–8), measured 3 (IQR 3–4)), and slightly longer than mMRC (median 1 (IQR 1–1)) and CAT (median 3 (IQR 2–5)). Even though the majority of patients required no help, more assistance was required by older patients. Compared with patients reporting by hand, completion over the telephone required somewhat longer time and more assistance.ConclusionMany patients with severe oxygen-dependent disease were unable or unwilling to assess symptoms over the telephone. However, among those able to participate, MDP and D-12 are feasible to measure multiple dimensions of breathlessness over the telephone.
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