ISSaQ 4.0: Innovation Scalability Self-Administered Questionnaire

ISSaQ 4.0 is designed to be used by any person or organization working in health and social research or health and social services, with and for patients and citizens. Given the complexity of the scaling process and the detailed nature of some of the statements, we recommend that the whole scaling team participate in filling out the questionnaire. The team should establish partnerships with all the scaling stakeholders, including users or user representatives, beneficiaries, organizations working in health research or health and social services, funding bodies and decision makers, all of whose perspectives are necessary for developing the scaling of the innovation. Thus, the data, information and reflections can be shared by the group considering their experiences and possibilities.

We mobilized best practices for inclusive patient-centred research in designing this tool. ISSaQ 4.0 was created using the iKT approach (Integrated Knowledge Translation) with input from patient and citizen partners at every stage of its development. The tool therefore encourages patient and citizen involvement in scaling. For involving patients and citizens, teams should use plain language in their discussions and clearly identify the skills of patient and citizen participants that can help in assessing the scalability of the innovation.

You can use the ISSaQ 4.0 tool at different stages of the scaling of your innovation:

Refers to how well it achieves its intended outcomes or goals in addressing a specific problem or need. It typically measures the impact, efficiency, and overall success of the innovation in practical applications.

Groups of people distinguished by their ethnic background, culture, or perceived race, who experience social, economic, or political marginalization due to societal structures and biases. The term “racialized” highlights the social process of assigning racial identities, often leading to discrimination or unequal treatment.

Data obtained using rigorous scientific methods such as experimental or observational studies. Evidence-based data can include quantitative data (numbers, statistics) and/or qualitative data (observations, testimonials).

The first implementation of the innovation in a pilot or experimental context.

Team responsible for scaling the innovation.

Interventions that are new, or perceived as new by their beneficiaries, or interventions adapted to new contexts.

The context in which an innovation was implemented for the first time.

Infrastructure such as equipment, measures and qualified human resources necessary for guiding and monitoring scaling.

Partnerships necessary for scaling the innovation, e.g. partners from various sectors such as financial organizations, suppliers, community associations and governments.

The context/s into which an innovation will be scaled.

The institutional arrangements needed to scale an innovation, such as authorizations from management, a governance committee and political and community support.

Active participation of patients and citizens in the scaling of innovations in health and social services through collaboration and the co-production of ideas, plans, documents, tools, solutions and evaluations throughout all phases of the process.

Language that is understandable and usable by as many people as possible, including those with different abilities or needs.

Barriers at the level of political decision-making and public policy implementation that may block scaling. These may be conflicts of interest between different groups, bureaucracy and institutional resistance to change, and legal or regulatory constraints.

Qualified personnel who are either already able to contribute to scaling the innovation, or who are willing and able to be trained to do so.

Relevant data are consistent, appropriate and respond to a specific question or scaling goal. High-quality data are reliable in terms of the data collection methodology, the sampling, and the validity of the measures.

Potential of an innovation to be expanded, replicated and adapted to new contexts while maintaining its effectiveness and thus increasing its impact.

Components that have been identified in the scientific literature as essential to the success of scaling innovations in health and social services.

Effort to increase the impact of a health innovation proven effective in local or experimental contexts through expanding, replicating and adapting it.

The stage before scaling, including establishing the team, partnerships, infrastructure and everything else necessary for proceeding with scaling. Some authors recommend developing a scaling plan at this stage.

User representatives, beneficiaries, organizations and persons working in health research or health and social services, funding bodies and decision makers, all of whose perspectives are necessary for scaling the innovation.

Elements that take into account inherent social and power inequalities in society that result in, for example, differences in access to health care for women, men, cisgender, transgender and non-binary persons.

The population and/or services that will benefit from scaling the innovation.

Persons, communities and groups frequently faced with discrimination and prejudice because of their characteristics or position in the social structure. These are people of African descent, Indigenous people, Roma, Sinti and Travellers, people belonging to national, ethnic, religious or linguistic minorities, migrants, refugees, asylum seekers, internally displaced people, people living in extreme poverty, women, LGBTQ2S+ people, people with disabilities, and older people.