Stakeholder Value Propositions Research Articles

The Cancer Equity Compass: Interactive maps showing the association between social determinants of health and cancer disparities.

149 Background: Cancer incidence and mortality in Black, Hispanic and Native American populations is over twice that in the White population for some prevalent cancers. A new, publicly available mapping tool, the Cancer Equity Compass (CEC), was developed to inform data-driven initiatives to improve equity by identifying community factors associated with cancer disparities. The tool is comprised of interactive maps that visually reveal correlations between two variables. Development of the tool began with assembling a group of nine advisors with expertise in cancer prevention, treatment and health equity. These experts inform the strategy, data sources, variables of interest, and stakeholder value propositions for the CEC. Methods: The data source for the CEC is a national, multi-level database developed using individual, health system, and community data, aggregated by county. For the three most common cancers in the U.S., breast, prostate and lung, screening and prevalence rates were collected from 2021 Medicare 5% research identifiable files and mortality rates from 2020 SEER Medicare rates. These metrics were each mapped with a variety of social determinants of health (SDOH) variables. Population rates for minorities, education, poverty, income and unemployment, and an air quality measure were from the Area Health Resources File. Environmental risks were derived from the Environmental Justice Index and included environmental burden (ranked 0-17 for pollution, toxic sites, built environment, transportation infrastructure and water pollution), air pollution (ranked 0-4), and social vulnerability (ranked 0-14 across socioeconomic variables). Results: Each map includes one cancer metric and one SDOH variable. Each variable is stratified to show the top quartile, middle 50%, and bottom quartile. The choropleth heat maps, created on Tableau, display 9 colors representing each combination of the three levels (>75%, 25-75%, <25%) for both mapped variables. The CEC currently has 140 maps presenting visualizations of county SDOH associations with cancer disparities. Conclusions: The expert advisors on the project have outlined four avenues for the CEC to aid efforts to improve cancer equity: 1) Enhance diversity in clinical trial recruitment and data registries through targeted site recruitment; 2) Identify high opportunity targets for improving equity and informing solutions; 3) Identify common correlates of disparities within and across U.S. counties to direct priorities for national policy and programs for large-scale impact; and 4) Measure change to support improvement efforts and report impact of equity initiatives. The CEC will be expanded with additional measures including healthcare access. The goal is use by stakeholders and changemakers who can apply the reported data to fuel advocacy efforts and enact positive change.

A Comprehensive Framework for Evaluating the Value Created by Real-World Evidence for Diverse Stakeholders: The Case for Coordinated Registry Networks.

This manuscript presents a comprehensive framework for the assessment of the value of real-world evidence (RWE) in healthcare decision-making. While RWE has been proposed to overcome some limitations of traditional, one-off studies, no systematic framework exists to measure if RWE actually lowers the burden. This framework aims to fill that gap by providing conceptual approaches for evaluating the time and cost efficiencies of RWE, thus guiding strategic investments in RWE infrastructure. The framework consists of four components: (114th Congress. 21st Century Cures Act.; 2015. https://www.congress.gov/114/plaws/publ255/PLAW-114publ255.pdf .) identification of stakeholders using and producing RWE, (National Health Council. Glossary of Patient Engagement Terms. Published 2019. Accessed May 18. 2021. https://nationalhealthcouncil.org/glossary-of-patient-engagement-terms/ .) understanding value propositions on how RWE can benefit stakeholders, (Center for Drug Evaluation and Research. CDER Patient-Focused Drug Development. U.S. Food & Drug Administration.) defining key performance indicators (KPIs), and (U.S. Department of Health and Human Services - Food and Drug Administration: Center for Devices and Radiological Health and Center for Biologics Evaluation and Research. Use of Real-World Evidence to Support Regulatory Decision-Making for Medical Devices - Guidance for Industry and Food and Drug Administration Staff. 2017. http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guida .) establishing metrics and case studies to assess value. KPIs are categorized as 'better, faster, or cheaper" as an indicator of value: better focusing on high-quality actionable evidence; 'faster,' denoting time-saving in evidence generation, and 'cheaper,' emphasizing cost-efficiency decision compared to methodologies that do not involve data routinely collected in clinical practice. Metrics and relevant case studies are tailored based on stakeholder value propositions and selected KPIs that can be used to assess what value has been created by using RWE compared to traditional evidence-generation approaches and comparing different RWE sources. Operationalized through metrics and case studies drawn from the literature, the value of RWE is documented as improving treatment effect heterogeneity evaluation, expanding medical product labels, and expediting post-market compliance. RWE is also shown to reduce the cost and time required to produce evidence compared to traditional one-off approaches. An original example of a metric that measures the time saved by RWE methods to detect a signal of a product failure was presented based on analysis of the National Cardiovascular Disease Registry. The framework presented in this manuscript offers a comprehensive approach for evaluating the value of RWE, applicable to all stakeholders engaged in leveraging RWE for healthcare decision-making. Through the proposed metrics and illustrated case studies, valuable insights are provided into the heightened efficiency, cost-effectiveness, and improved decision-making within clinical and regulatory domains facilitated by RWE. While this framework is primarily focused on medical devices, it could potentially inform the determination of RWE value in other medical products. By discerning the variations in cost, time, and data utility among various evidence-generation methods, stakeholders are empowered to invest strategically in RWE infrastructure and shape future research endeavors.

Topic Modelling of Management Research Assertions to Develop Insights into the Role of Artificial Intelligence in Enhancing the Value Propositions of Early-Stage Growth-Oriented Companies

The article suggests a Value Proposition (VP) framework that enables analysis of the beneficial impact of Artificial Intelligence (AI) resources and capabilities on specific VP activities. To develop such a framework, we examined existing business and management research publications to identify and extract assertions that could be used as a source of actionable insights for early-stage growth-oriented companies. The extracted assertions were assembled into a corpus of texts that was subjected to topic modelling analysis—a machine learning approach to natural language processing that is used to identify latent themes in large corpora of text documents. The topic modelling resulted in the identification of seven topics. Each topic is defined by a set of most frequent words co-occurring in a distinctive subset of texts that could be interpreted in terms of activities constituting the core elements of the VP framework. We then examined each activity in terms of its potential to be enhanced by employing AI resources and capabilities. The interpretation of the topic modelling results led to the identification of seven topics: (1) Value created; (2) Stakeholder value propositions; (3) Foreign market entry; (4) Customer base; (5) Continuous improvement; (6) Cross-border operations; and (7) Company image. The uniqueness of the adopted topic modelling approach consists in the quality of the assertions and the interpretation of the seven topics as an activity framework, i.e., in its capacity to generate actionable insights for practitioners. The additional analysis suggests that there is a potential for AI to enhance the emerging four core elements of the VP framework: Value created, Stakeholder value propositions, Foreign market entry, and Customer base. More importantly, we found that the greatest number of assertions related to activities that could be enhanced by AI are part of the Customer base topic, i.e., the topic that is most directly related to the growth potential of the companies. In addition, the VP framework suggests that a company’s customer base growth is continuously enhanced through a positive loop enabled by activities focused on the Continuous improvement of the activities and the amount of Value created, the alignment of Stakeholder value propositions, and companies’ Foreign market entry. Thus, the multiple-stakeholder perspective on VP development and foreign market entry appears as a factor that helps in understanding the beneficial impact of AI on the enhancement of the VP of early-stage growth-oriented companies.

Understanding Project Stakeholder Planning, Identification and Engagement: A Phenomenological Approach

This research explored stakeholder management practices by conducting qualitative interviews with 71 seasoned project managers. Through phenomenological principles and inductive coding, findings revealed inconsistencies in stakeholder planning, identification, and engagement. The research underscores the importance of early stakeholder identification using both formal and informal techniques. Additionally, it identifies a gap between academic literature and actual practitioner methodologies, particularly regarding stakeholder registers, mapping, and value propositions. The study suggests a need for structured and standardized stakeholder management strategies, especially given the evolving stakeholder dynamics in projects. The findings offer actionable insights for professionals and organizations seeking to improve stakeholder management techniques.

Stories of value: Business model innovation adding value propositions articulated by Slow Storytelling

This article proposes an empirically derived method, Slow Storytelling, to construct and articulate value propositions, as a contribution to Business Model Innovation. Organizational actors and customers must be clear on what value an enterprise, product or service offers. This is increasingly important for products and services that leverage social, cultural, and environmental values. However, few existing models provide the framework and method to facilitate business articulation of value proposition for stakeholders. Our participatory ethnographic study conducted before and during COVID-19 in craft micro-enterprises in Uzbekistan addresses this gap. We co-created a novel method, ‘Slow Storytelling’, to innovate, enhance and articulate value propositions, by mobilizing and communicating the social, cultural, and environmental values; for example, by explaining the lived and sustainable history of the product. The method consists of eight steps to elicit consumers’ emotional connection with craft producers and trigger attention towards their social and environmental impact. Slow Storytelling can be adopted beyond our craft setting, to support the construction and articulation of value propositions.

Application Of The Balanced Scorecard As A Measurement Model Of The Balance Of Stakeholder Value Proposition

The balanced scorecard (BSC) is one of the concepts of a managerial performance measurement system that has a function and significance for companies carrying out strategic management by using four measurement perspectives in a systematic and integrated manner. This study uses the balanced scorecard, and management can identify, formulate, and create a value proposition that is balanced and proportionate among its stakeholders (stakeholders). This study aims to determine how the company's performance benchmarks and stakeholder value propositions use the balanced scorecard approach. The type and approach of this research are descriptive qualitative. The data analysis model is carried out in two ways: First, qualitatively, namely by describing according to language, sentences and perspectives to get a logical understanding and relevant to the research objectives. Second, using the balanced scorecard approach, namely data analysis made in numbers based on the balanced scorecard approach. This study explains how the general concept of the balanced scorecard, the four perspectives of measuring the balanced scorecard, the implementation of the balanced scorecard, and the balance of stakeholder value propositions. The results showed the measurement of the balanced scorecard at PT. "X" indicates that the company has a good set of benchmarks in implementing the balanced scorecard. The results also show that several balanced scorecard perspectives are proven to positively impact company performance in all views, including financial perspective, customer perspective, internal business process perspective, and learning and growth perspective. This study is due to the company's ability to correctly identify, formulate and determine stakeholder value propositions through a balanced scorecard approach.

The stakeholder value proposition of digital platforms in an urban ecosystem

Using a mixed-method approach, we assess the conditions under which digital platforms can successfully deliver their stakeholder value propositions (SVP)—declarative statements that the digital platform makes about how it adds value or solves a problem for target stakeholders—in cities. We examine the popular digital platform Airbnb in the touristic city of Barcelona and analyze the extent to which it delivers its value proposition to guests, hosts, and the city. Evidence suggests that Airbnb in Barcelona closely resembles the existing hotel industry, reinforcing over-tourism and inequality, which explains the adverse reactions Airbnb has faced from the city. We contrast this with the case of a nearby non-touristic city, Igualada, where the platform has delivered on its SVP. Our findings suggest that, while complex and gradual, the process of joint value creation between the digital platform and its stakeholders is possible and can be beneficial under conditions of mutual adjustment and business model adaptation. We uncover the substantive, localized, and dynamic characteristics of the SVP design process and discuss the academic, policymaking, and managerial implications of adequate platform design.

The Value Creation Determinants of the Global Software Engineering Industry

Every requirement in the software application does not add value to the end users equally where the stakeholders are benefited through them. Majority of the current software engineering practices are formed and done in a value neutral way. With the recent demand for the global software engineering, many organizations have decided to either initiate their own technology centers in the low-cost countries or to partner with outsourced companies to get the benefits of it. However, the practitioners tried applying the traditional software development processes without a proper customization of them to best suit for the distributed teams. Due to the nature of this industry, those traditional processes have further eroded the value with unnecessary checkpoints and gates. This research therefore was carried out to identify the value creation dimensions and their influence creating value with special reference the global software engineering industry. For that, a systematic literature review was carried out and findings were categorized to five areas based on the research questions. They are benefit realization in the delivery process, eliciting and reconciling the requirements for stakeholder value proposition, business case analysis against the business processes, assessment of the value, risk, and opportunity through the frameworks and finally value based monitoring and control through the software development methodology. Mapping the development processes against these areas can change the value addition on the global software engineering industry.

Molecular chlamydia and gonorrhoea point of care tests implemented into routine practice: Systematic review and value proposition development.

Sexually Transmitted Infections, including Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), continue to be a global health problem. Increased access to point-of-care-tests (POCTs) could help detect infection and lead to appropriate management of cases and contacts, reducing transmission and development of reproductive health sequelae. Yet diagnostics with good clinical effectiveness evidence can fail to be implemented into routine care. Here we assess values beyond clinical effectiveness for molecular CT/NG POCTs implemented across diverse routine practice settings. We conducted a systematic review of peer-reviewed primary research and conference abstract publications in Medline and Embase reporting on molecular CT/NG POCT implementation in routine clinical practice until 16th February 2021. Results were extracted into EndNote software and initially screened by title and abstract by one author according to the inclusion and exclusion criteria. Articles that met the criteria, or were unclear, were included for full-text assessment by all authors. Results were synthesised to assess the tests against guidance criteria and develop a CT/NG POCT value proposition for multiple stakeholders and settings. The systematic review search returned 440 articles; 28 were included overall. The Cepheid CT/NG GeneXpert was the only molecular CT/NG POCT implemented and evaluated in routine practice. It did not fulfil all test guidance criteria, however, studies of test implementation showed multiple values for test use across various healthcare settings and locations. Our value proposition highlights that the majority of values are setting-specific. Sexual health services and outreach services have the least overlap, with General Practice and other non-sexual health specialist services serving as a "bridge" between the two. Those wishing to improve CT/NG diagnosis should be supported to identify the values most relevant to their settings and context, and prioritise implementation of tests that are most closely aligned with those values.

Editorial: Aligning Multiple Stakeholder Value Propositions: the challenge of new companies committed to scaling early and rapidly

The Value Proposition (VP) development practices of a company are an expression of the most fundamental organizing principles of its business (Webster, 2002). It has been defined as “a strategic tool facilitating communication of an organization’s ability to share resources and offer a superior value package to targeted customers” (Payne et al., 2017). At the same time, the

Analysis of Strategic Renewable Energy, Grid and Storage Capacity Investments via Stackelberg-Cournot Modelling

With increasing decarbonisation and accessibility to our energy systems and markets, there is a need to understand and optimise the value proposition for different stakeholders. Game-theoretic models represent a promising approach to study strategic interactions between self-interested private energy system investors. In this work, we design and evaluate a game-theoretic framework to study strategic interactions between profit-maximising players that invest in network, renewable generation and storage capacity. Specifically, we study the case where grid capacity is developed by a private renewable investor, but line access is shared with competing renewable and storage investors, thus enabling them to export energy and access electricity demand. We model the problem of deducing how much capacity each player should build as a non-cooperative Stackelberg-Cournot game between a dominant player (leader) who builds the power line and renewable generation capacity, and local renewable and storage investors (multiple followers), who react to the installation of the line by increasing their own capacity. Using data-driven analysis and simulations, we developed an empirical search method for estimating the game equilibrium, where the payoffs capture the realistic operation and control of the energy system under study. A practical demonstration of the underlying methodology is shown for a real-world grid reinforcement project in the UK. The methodology provides a realistic mechanism to analyse investor decision-making and investigate feasible tariffs that encourage distributed renewable investment, with sharing of grid access.

Grassroots Resistance to Digital Platforms and Relational Business Model Design to Overcome It: A Conceptual Framework

Although extant research has studied incumbent resistance to digital platforms, it provides little understanding about when grassroots collective action by other ecosystem stakeholders against the digital platform is likely. In this paper, we identify the scope conditions detailing when local stakeholders can initiate grassroots collective action against the digital platform, a unique context characterized by fast growth, distributed innovation, role flexibility, and direct local connectivity, and propose viable solutions. Our conceptual framework suggests that grassroots collective action against the digital platform is most likely when the digital platform operates with localized scarce assets or localized precarious labor and when actors express their grievances through formalized channels. We combine business model design and stakeholder management perspectives to develop design-based solutions that involve a multisided business model structure, an inclusive stakeholder value proposition, and an ecosystem-centered governance. We call the combination of such design efforts relational business model design. To the incipient theory of digital platforms, we contribute a stakeholder-centered view of platform business models operating within local ecosystems, bridging research on collective action and stakeholder management with strategic management of platforms.

Early Implementation of Comprehensive Medication Management within an Academic Medical Center Primary Care Pharmacy Team.

University of Utah Health is an academic health care system that serves residents in Utah and beyond. Clinical pharmacists with the health care system's pharmacy primary care services (PPCS) team provide medication education, population-based care, and medication management through collaborative practice agreements. With the expansion of clinical pharmacist and technician positions and services, the need to measure and assess the impact of pharmacy services and create a value proposition for internal and external stakeholders became an important goal, and the decision was made to better align practices across all PPCS sites. This paper highlights University of Utah Health's approach to implement comprehensive medication management (CMM) across all primary care clinics with embedded clinical pharmacy staff and subsequent evaluation of implementation fidelity. Implementation of CMM was assisted by participation in the National A3 Collaborative and by using selected principles from the Active Implementation Framework. Stages of implementation included exploration, instillation, and initiating improvement cycles. An implementation team consisting of PPCS employees was created to help with standardization, developing implementation plans, and creating a dissemination strategy for all PPCS team members. The CMM care process was subsequently presented and implemented by clinical pharmacists in primary care clinics. Following implementation, fidelity measures were collected including identification and resolution of medication therapy problems (MTPs) and responses from a questionnaire distributed to the clinical pharmacists to self-report understanding and implementation of CMM key elements. The number and type of MTPs identified were tracked over 18 months. Within the measurement window, clinical pharmacists identified 17,953 MTPs. Of the total number of MTPs identified, 21% were related to indication, 53% to efficacy, 15% to safety and 11% to adherence. The questionnaire was distributed to clinical pharmacists 9 months after CMM implementation, with a 71% response rate. Pharmacists reported "always" or "often" performing each step in the patient care process as follows: indication (93%), effectiveness (93%), safety (87%), and adherence (93%). Reported barriers to implementation of the CMM include lack of time to complete all aspects of the process efficiently, lack of a standardized format for documentation, and changing practice habits. Implementation of a CMM process within University of Utah Health's PPCS services with the help of a national collaborative and implementation framework yielded identification of 17,953 MTPs over 18 months and foundational fidelity to core principles.

Status, stress and fit: comparing the faculty stress impact of university consolidations

PurposeInstitutions of higher education face challenges of fiscal responsibility and their value proposition for students and other stakeholders they serve. Strategies used in business sectors, such as merger and acquisition, are being increasingly adopted by higher education governing boards, especially for public institutions and systems. The purpose of this paper is to guide policy decisions related to university mergers.Design/methodology/approachThis paper focuses on the interplay between the pre-merger status of the institution, the individual faculty member's sense of belonging, and their commitment to the organization on levels of job-related stress, which has well-established negative impacts on individual and organizational performance. Using survey data collected at the same time post-merger from two different universities within the same state system, we explore regression models to identify similarities and differences between the faculty responses in terms of the impact of the merger on faculty stress.FindingsDifferences are found between the two universities in terms of faculty stress with faculty of one low status institution pre-merger having significantly higher stress post-merger. A case is presented for differences in stress based on a part on differences in how the mergers were managed at the system and university levels.Practical implicationsThis research is instructive for higher education policy makers and university administrators as the institution of higher education continues this type of transformation.Originality/valueThis paper examines the impact of mergers on a university's single-most important asset, faculty. Comparative and timely faculty survey results from two related universities early post-merger provide valuable insights for leaders in higher education.

Визначення бізнес-моделі університету на основі синтезу підходів до бізнес-моделі підприємства

The article investigates and structures the genesis of approaches of domestic and foreign scientists to the concept of model, as a result the strategic, customer-oriented, value, process, system approach, as well as approaches that identify the business model as a management tool, mechanism, define it. as a cognitive system. The approaches of scientists to the filling of the business model with components are studied, which proves its uniqueness and possibility of use in different fields. It is determined that when developing a business model of the university it is advisable to follow a comprehensive approach that combines strategic, value, customer-oriented, process and system approaches. The understanding of the university business model as a conceptual tool based on a strategic vision of higher education development, including an interconnected set of components of creating a value proposition for stakeholders and the university's ability to generate revenue to ensure financial stability. The components of the business model of Osterwalder A. and Pigneur Y. for domestic universities have been filled in meaningfully.

Call for Papers: Aligning multiple stakeholder value propositions: the challenge of new companies committed to scale early and rapidly

Call for Papers: Aligning multiple stakeholder value propositions: the challenge of new companies committed to scale early and rapidly

The economic and environmental performance of biomass as an “intermediate” resource for power production

Electricity powered by biomass is expanding. We examine four recent biopower plants and global benchmarks to assess their overall performance, confirming the characterization of biomass as an “intermediate” resource for power production. Electricity from biomass is more expensive than energy efficiency, natural gas, wind, or solar but substantially less expensive than new coal or nuclear plants. Compared to coal and natural gas per MWh produced, the NOx and SO2 emissions of biopower are also intermediate. We confirm that current investments in biopower can be attributed to an array of stakeholder value propositions extending beyond basic economic and environmental metrics.

The Era of Artificial Intelligence in Malaysian Higher Education: Impact and Challenges in Tangible Mixed-Reality Learning System toward Self Exploration Education (SEE)

Artificial Intelligence (AI) is the creation of a smart machine that has human behaviour and response. AI in the education sector is able to interact, assist, and guide students through Self-Exploration Education (SEE) in Self Determined Learning (SDL) or Heutagogical technique, such as current, but semi-automatic learning systems. Malaysian higher education institutions are forced to adapt to such a radical change in order to stay competitive and fulfill their stakeholder needs. Everyone is born as a genius, with curiosity to explore the environment through experiments. This study examines the effect of SDL on SEE in Tangible Mixed-Reality Learning System until 2030. It does that under two different lenses: First, the effect on the value proposition and the business models of the SDL. Second, it identifies hurdles for the implementation and draws strategic implications for the SDL Tangible Mixed-Reality Learning System. However, in practice, SEE is still very much focused on spreading facts rather than encouraging personal exploration. Conducting exploration of learning in the classroom can be complicated for adult learning or andragogy and is limited by virtue, money and work infrastructure. But what if we can create a middle ground between learning and fiction, the world in which adults learn and explore in ways that may be impossible in real life but still true to the transfer of knowledge? The project is to craft an imaginative and accessible tool to help adults develop scientific minds and practices through self-exploration or Do-it-yourself DIY with a mixed reality learning system that empowers adults to know the invisible and investigate hard through exploration. By 2030 the likeliest scenario is that fully Self-Exploration is solely available for particularly high-value use cases, affecting the value proposition toward provision of education services, an increase of stakeholder and value-centric value propositions fostered by continuous interactions between the Heutagogical technique and the stakeholder.

Value-based assessment of robotic pancreas and liver surgery.

Current healthcare economic evaluations are based only on the perspective of a single stakeholder to the healthcare delivery process. A true value-based decision incorporates all of the outcomes that could be impacted by a single episode of surgical care. We define the value proposition for robotic surgery using a stakeholder model incorporating the interests of all groups participating in the provision of healthcare services: patients, surgeons, hospitals and payers. One of the developing and expanding fields that could benefit the most from a complete value-based analysis is robotic hepatopancreaticobiliary (HPB) surgery. While initial robot purchasing costs are high, the benefits over laparoscopic surgery are considerable. Performing a literature search we found a total of 18 economic evaluations for robotic HPB surgery. We found a lack of evaluations that were carried out from a perspective that incorporates all of the impacts of a single episode of surgical care and that included a comprehensive hospital cost assessment. For distal pancreatectomies, the two most thorough examinations came to conflicting results regarding total cost savings compared to laparoscopic approaches. The most thorough pancreaticoduodenectomy evaluation found non-significant savings for total hospital costs. Robotic hepatectomies showed no cost savings over laparoscopic and only modest savings over open techniques. Lastly, robotic cholecystectomies were found to be more expensive than the gold-standard laparoscopic approach. Existing cost accounting data associated with robotic HPB surgery is incomplete and unlikely to reflect the state of this field in the future. Current data combines the learning curves for new surgical procedures being undertaken by HPB surgeons with costs derived from a market dominated by a single supplier of robotic instruments. As a result, the value proposition for stakeholders in this process cannot be defined. In order to solve this problem, future studies must incorporate (I) quality of life, survival, and return to independent function alongside data such as (II) intent-to-treat analysis of minimally-invasive surgery accounting for conversions to open, (III) surgeon and institution experience and operative time as surrogates for the learning curve; and (IV) amortization and maintenance costs as well as direct costs of disposables and instruments.

The Key Roles of Maintainability in an Ontology for System Qualities

AbstractIn our INCOSE IS 2015 paper, “An Initial Ontology for System Qualities,” (SQs), we provided an IDEF5 class hierarchy of upper‐level SQs, where the top level reflected classes of stakeholder value propositions (Mission Effectiveness, Resource Utilization, Dependability, Flexibility), and the next level identified means‐ends enablers of the higher‐level SQs. In experimenting with, refining and formalizing the ontology, we focused on a depth‐first approach on a chosen SQ: Maintainability. It is key to reducing 75% of most systems’ life cycle costs. Also Maintainability plays key roles in three of the four top‐level SQs: Resource Utilization (now called Life Cycle Efficiency) Dependability, and Flexibility (now called Changeability). Dependability also needs Maintainability to relate Reliability to Availability; and Changeability also needs Maintainability to address new system challenges and opportunities. This paper summarizes resulting changes in the SQ ontology, and also provides examples of Maintainability need and use, quantitative relations where available, and summaries and references on improved practices.