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Identifying and unravelling persistent problems

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  • Schuitmaker, Tjerk Jan

Abstract

Persistent problems feature prominently in transition management and system innovation literature. They serve both as a point of departure, and as justification for the contention that a system innovation is needed. The concept ‘persistent problem’ however is underdeveloped; it is used to label (symptoms of) problems that appear to be complex, uncertain, difficult to manage, and difficult to grasp, but as such provides no way for unravelling how the persistence of these problems actually works. A better understanding can help new practices, like niche-innovations, to overcome enduring problems, contributing to a transition or system innovation. Drawing on the work of Giddens and others, this paper proposes a conceptualisation that can be used to identify and unravel persistent problems. The conceptual framework is built on the notion of systemic reproduction, and further operationalised by iteratively combining a historically informed system analysis with an actor-guided system analysis. The historically informed analysis focuses on features that are exactly the strongholds of the current system, but are said to have negative side effects. In concurrence with that, the systemic reproduction of these negative side effects can be unravelled by analysing how new practices shape their agency in relation to their direct environment. A persistent problem then is a systemically reproduced negative side effect of a success factor of the system in focus. The operationalisation brings the conceptual framework to the actor level, and opens up possibilities for investigating how systemically embedded problems manifest themselves in the daily practice of actors that try to take on enduring problems. In the second part of the paper, this approach is illustrated by using it to unravel problems of tenability of the Dutch health care system. A historically informed analysis is integrated with an analysis of a new practice in health care that deals with patients who suffer from medically unexplained physical symptoms.

Suggested Citation

  • Schuitmaker, Tjerk Jan, 2012. "Identifying and unravelling persistent problems," Technological Forecasting and Social Change, Elsevier, vol. 79(6), pages 1021-1031.
    • Handle: RePEc:eee:tefoso:v:79:y:2012:i:6:p:1021-1031
    DOI: 10.1016/j.techfore.2011.11.008
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    Cited by:

    1. Lee, Carmen Kar Hang & Tse, Ying Kei & Ho, G.T.S. & Chung, S.H., 2021. "Uncovering insights from healthcare archives to improve operations: An association analysis for cervical cancer screening," Technological Forecasting and Social Change, Elsevier, vol. 162(C).
    2. Florian Hofmann & Melanie Jaeger‐Erben, 2020. "Organizational transition management of circular business model innovations," Business Strategy and the Environment, Wiley Blackwell, vol. 29(6), pages 2770-2788, September.
    3. Avelino, Flor & Wittmayer, Julia M. & Pel, Bonno & Weaver, Paul & Dumitru, Adina & Haxeltine, Alex & Kemp, René & Jørgensen, Michael S. & Bauler, Tom & Ruijsink, Saskia & O'Riordan, Tim, 2019. "Transformative social innovation and (dis)empowerment," Technological Forecasting and Social Change, Elsevier, vol. 145(C), pages 195-206.
    4. Simone Harmsen & Carina A C M Pittens & Eva Vroonland & Annemiek J M L van Rensen & Jacqueline E W Broerse, 2022. "Supporting health researchers to realize meaningful patient involvement in research: Exploring researchers’ experiences and needs [New Requirements for Patient and Public Involvement Statements in ," Science and Public Policy, Oxford University Press, vol. 49(5), pages 751-764.
    5. Iris Wanzenböck & Koen Frenken, 2018. "The subsidiarity principle: Turning challenge-oriented innovation policy on its head," Papers in Evolutionary Economic Geography (PEEG) 1806, Utrecht University, Department of Human Geography and Spatial Planning, Group Economic Geography, revised Jan 2018.
    6. Argatu Ruxandra, 2020. "Innovation capability assessment tools in social enterprises," Proceedings of the International Conference on Business Excellence, Sciendo, vol. 14(1), pages 91-101, July.
    7. Iris Wanzenböck & Joeri H Wesseling & Koen Frenken & Marko P Hekkert & K Matthias Weber, 0. "A framework for mission-oriented innovation policy: Alternative pathways through the problem–solution space," Science and Public Policy, Oxford University Press, vol. 47(4), pages 474-489.
    8. Markus M. Bugge & Teis Hansen & Antje Klitkou, 2016. "What Is the Bioeconomy? A Review of the Literature," Sustainability, MDPI, vol. 8(7), pages 1-22, July.
    9. Marinakis, Yorgos D. & Walsh, Steven T. & White, Reilly, 2024. "What is the relationship between sociotechnical transition and disruptive innovations?," Technological Forecasting and Social Change, Elsevier, vol. 199(C).
    10. Lisa S. Barsties & Frank S. van Steenbergen & Derk Loorbach, 2021. "Social Obstetrics as Niche-Development in Addressing Health Inequities," Sustainability, MDPI, vol. 13(22), pages 1-14, November.
    11. Elzen, Boelie & Bos, Bram, 2019. "The RIO approach: Design and anchoring of sustainable animal husbandry systems," Technological Forecasting and Social Change, Elsevier, vol. 145(C), pages 141-152.
    12. Edler, Jakob & Köhler, Jonathan Hugh & Wydra, Sven & Salas-Gironés, Edgar & Schiller, Katharina & Braun, Annette, 2021. "Dimensions of systems and transformations: Towards an integrated framework for system transformations," Working Papers "Sustainability and Innovation" S03/2021, Fraunhofer Institute for Systems and Innovation Research (ISI).
    13. Tjerk Jan Schuitmaker-Warnaar & Callum J. Gunn & Barbara J. Regeer & Jacqueline E. W. Broerse, 2021. "Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care," Sustainability, MDPI, vol. 13(21), pages 1-19, October.
    14. Lips, S.R. & Molenaar, J.M. & Schuitmaker-Warnaar, T.J., 2020. "Transforming maternity care: obstetric partnerships as a policy instrument for integration," Health Policy, Elsevier, vol. 124(11), pages 1245-1253.
    15. Markard, Jochen & Hoffmann, Volker H., 2016. "Analysis of complementarities: Framework and examples from the energy transition," Technological Forecasting and Social Change, Elsevier, vol. 111(C), pages 63-75.

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