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Abstract
Because systems of care are not uniform across communities, there is a need to better
document the process of system development, define the complexity, and describe the
development of the structures, processes, and relationships within communities engaged
in system transformation. By doing so, we begin to identify the necessary and sufficient
components that, at minimum, move us from usual care within a naturally occurring
system to a true system of care. Further, by documenting and measuring the degree
to which key components are operating, we may be able to identify the most successful
strategies in creating system reform. The theory of change and logic model offer a
useful framework for communities to begin the adaptive work necessary to effect true
transformation. Using the experience of two system of care communities, this new definition
and the utility of a theory of change and logic model framework for defining local
system transformation efforts will be discussed. Implications for the field, including
the need to further examine the natural progression of systems change and to create
quantifiable measures of transformation, will be raised as new challenges for the
evolving system of care movement.