Implementation Key Terms

A glossary of essential concepts used throughout the guide, offering clear definitions for key terms.

Assets

Existing resources, programs, partners, or systems, including those in your state/jurisdiction or at the national level, which can be built upon or leveraged to facilitate implementation. Assets are typically identified before the beginning or at the end of a phase, although emerging assets may be identified during a phase. 

Barriers

Impediments or challenges (including policies, lack of resources, strained relationships, challenging contexts, etc) that may cause conflict or impede the system change. 

Core Components

Core components are the essential parts of an intervention or innovation. You can think of them like the “active ingredients” that allow your intervention to work. Core components can be developed and refined over time but are the “what” to the system change you are hoping to make.  

Champions of Change

CYSHCN partners that are necessary to support system-level change. This may include families, providers, other individuals with lived experience, local and state-level staff, community partners, etc.  

Feasibility

Assessing the practicality of implementing the change given your current resources, staffing, and integration with existing systems.  

Evidence-Based Intervention (EBI)

An EBI is a program, policy, innovation, or practice that has been proven effective in addressing a specific program or outcome. It is a well-defined intervention or innovation with well-documented processes. An EBI can serve as a starting point for a system-level innovation you plan to implement.  

Facilitators

Resources or advantages (including policies, funding, strong partnerships, positive changes in mindsets, etc.) that make implementing the system-change effort easier or smoother.  

Frameworks for System Change

Most complex system-level changes do not have an EBI, but may instead focus on various aspects of systems. Some examples of frameworks include the Iceberg Model and the Water of Systems Change framework. 

Feedback Loops

A system of continuous communication between the implementation team, community members, and partners. Feedback loops are essential for monitoring program progress, ensuring community engagement, and allowing you to make necessary adjustments based on data and community input.  

Implementation Teams

A group of stakeholders responsible for the implementation of a complex initiative; membership may change over time as they actively make decisions and support each phase of implementation. 

Needs

Existing or anticipated gaps in care, resources, or relationships that influence overall wellbeing for CYSHCN. Needs are typically identified before the beginning or at the end of a phase, although emerging needs may be identified during a phase. 

Outcomes

The specific, measurable changes or results that you would like to occur. They reflect the effectiveness of the program and can include both immediate effects (eg, improved access to specialized health care services or better coordination of care between providers) and long-term impacts (eg, improved health status, increased quality of life, or enhanced school performance for CYSHCN). It is crucial to have clearly identified outcomes and plans for measuring these outcomes to assess the success of the intervention, and to guide future improvements. 

Pilot

When making system-level changes, many CYSHCN teams start piloting the changes or innovation in a limited geographic location, with a limited group of children, or some other small “test of change.” Pilots allow teams to analyze whether they are making the intended outcomes they would hope to make and allow for easier scale for the next phase by problem-solving issues as they arise.