Stakeholders and in particular customers are an important source for business model innovation. Especially for sustainable business models, stakeholder integration may radically change the business logic and help to revise the business model. In this process cognition plays a central role, challenging basic assumptions and changing the dominant logic. In this paper we explore how interactions with the network contribute to making a cognitive shift in development of a sustainable business model. We build on three cases and closely look at the commercialisation stage in which a change of cognition and redesign of the business model take place. Our findings show that network interaction changes the dominant logic in business model innovation in two ways: by triggering a cognitive shift and by contributing to business model redesign. Our main contribution is the conceptualization of three interrelated shaping processes: market approach shaping, product/service offering shaping and credibility shaping. They provide a fine-grained perspective on value creation through collaborative networks and add to the business model literature by providing a framework to study the role of networks and cognition in business model innovation. For practitioners the shaping processes may support business model redesign and building relationships to advance commercialisation of sustainability-oriented innovations.
Introduction Radical cystectomy (RC) is the standard treatment for patients with non-metastatic muscle-invasive bladder cancer, as well as for patients with therapy refractory high-risk non-muscle invasive bladder cancer. However, 50–65% of patients undergoing RC experience perioperative complications. The risk, severity and impact of these complications is associated with a patient’s preoperative cardiorespiratory fitness, nutritional and smoking status and presence of anxiety and depression. There is emerging evidence supporting multimodal prehabilitation as a strategy to reduce the risk of complications and improve functional recovery after major cancer surgery. However, for bladder cancer the evidence is still limited. The aim of this study is to investigate the superiority of a multimodal prehabilitation programme versus standard-of-care in terms of reducing perioperative complications in patients with bladder cancer undergoing RC.Methods and analysis This multicentre, open label, prospective, randomised controlled trial, will include 154 patients with bladder cancer undergoing RC. Patients are recruited from eight hospitals in The Netherlands and will be randomly (1:1) allocated to the intervention group receiving a structured multimodal prehabilitation programme of approximately 3–6 weeks, or to the control group receiving standard-of-care. The primary outcome is the proportion of patients who develop one or more grade ≥2 complications (according to the Clavien-Dindo classification) within 90 days of surgery. Secondary outcomes include cardiorespiratory fitness, length of hospital stay, health-related quality of life, tumour tissue biomarkers of hypoxia, immune cell infiltration and cost-effectiveness. Data collection will take place at baseline, before surgery and 4 and 12 weeks after surgery.Ethics and dissemination Ethical approval for this study was granted by the Medical Ethics Committee NedMec (Amsterdam, The Netherlands) under reference number 22–595/NL78792.031.22. Results of the study will be published in international peer-reviewed journals.Trial registration number NCT05480735.
