Key Points

This article draws on a system-change framework developed by the Nicholson Foundation as part of a 20-year initiative to substantively change the state of New Jersey’s health and social welfare systems, and modifies and expands a single case study on system change to align with related ideas and concepts. A results-based accountability approach is integrated into the model to draw attention to the importance of monitoring and evaluation of population-based outcomes.

Drawing on extensive literature from systems change and performance management, the discussion provides insight and perspective on contemporary frameworks in systems change and the role of grantmaking foundations. The case highlights the importance of partner capacity, recognizing the need to build organizational and individual capacity as part of effective systems-change effort.

The article goes on to review the establishment of the Nicholson Model and introduce the seven components of the revised model: performance measurement, system expertise, nurturing partnerships and collaboration, utilizing complementary approaches, scaling and replicating promising practices, building organizational capacity, and developing leaders.

Scholars, researchers, and consultants can use the framework to build understanding of systems-change initiatives and their applicability to guide grantmaking investments.

Open Access