Many of us return from conferences energized by new perspectives, only to find that those ideas gradually recede amid job demands, competing priorities, and the realities of implementation. 

This is not because the ideas lack value, but because advancing them in meaningful and aligned ways requires intentionality, along with the time, space, and resources needed for implementation. 

What will we do with what we learned? 

Sitting on the plane after the conference, I began reviewing my notes. 

Across the pediatric presentations I attended, a consistent message emerged: successful implementation of integrated care depends not simply on selecting the right model, but on building the clinical, organizational, and workforce conditions that allow care to respond to the needs of children, families, and communities. 

What Makes Pediatric Integrated Care Different? 

The pediatric sessions painted a picture of a field defining itself on its own terms. While pediatric integrated behavioral health has often borrowed its frameworks, language, and implementation models from adult care, several presentations challenged attendees to consider what makes pediatric integrated care distinct. 

Discussions highlighted growing evidence that pediatric integrated care can improve access and outcomes for children and families. At the same time, many studies do not clearly identify the integration model being evaluated or report whether its core components were implemented, raising important questions about whether existing integration frameworks fully capture the realities of pediatric practice. 

Rather than asking how pediatric care can fit within established models, presenters encouraged participants to consider how those models might evolve to better reflect the needs of children, families, and pediatric care teams. 

From Vision to Infrastructure 

Yet defining pediatric integrated care is only part of the challenge. Pediatric models must also be translated into reliable everyday practice. Several sessions examined the systems, workflows, and infrastructure needed to accomplish this. 

Clinical pathways, implementation frameworks, quality improvement methods, and the updated AHRQ Integrated Behavioral Health and Primary Care Playbook underscored a common lesson: effective integration must be intentionally designed rather than expected to emerge on its own. 

Whether building pathways for ADHD and autism evaluation, establishing warm handoff workflows, or developing population-based care strategies, practices must create structures that support consistent delivery of evidence-based care while remaining adaptable to local circumstances and populations. 

Rethinking the Clinical Encounter 

Integrated behavioral health interventions in primary care are not simply abbreviated versions of specialty treatment. Presentations addressing behavioral change for common pediatric concerns described approaches designed around what primary care can do particularly well: intervene early, deliver a minimum effective intervention, and determine when additional care is warranted. 

This reframing matters because it defines brief intervention by its purpose and setting, not merely by its duration. 

Building Teams for Integrated Care 

Even the most thoughtfully designed workflows and interventions depend on the people delivering them. This reality surfaced repeatedly throughout the conference, highlighting workforce development as a critical ingredient in successful integration efforts. 

Presenters emphasized the value of structured onboarding, role clarification, ongoing training, and interdisciplinary collaboration in helping behavioral health clinicians function effectively within the pediatric medical home. Workforce development therefore emerged as the link between implementation plans and consistent patient care. 

Seeing Beyond the Visit 

Beyond individual clinicians and encounters, presenters also encouraged participants to think at the level of entire populations. Several sessions illustrated how registries, screening systems, and data-informed workflows can help practices identify needs before they become crises. 

The PPOC Pediatric Suicide Risk Registry illustrated how data systems, systematic screening, and structured follow-up can help practices identify risk earlier and coordinate care more reliably. Related examples showed how population-based approaches can also inform wellness examinations, care coordination, Collaborative Care Management, and clinical pathway development. 

Together, these efforts demonstrated how population management can help practices move from reactive care toward earlier, more systematic, and potentially more equitable intervention. 

The Bigger Picture 

Across the sessions, another theme emerged. Discussions focused less on identifying a single model of integrated care and more on understanding the conditions required for integration to work for particular patients, families, teams, and communities. 

The pediatric presentations reflected this orientation in several ways. Interventions were adapted to developmental stages, workflows were shaped by family needs, and implementation strategies were influenced by local resources and constraints. Integrated care was presented not as a fixed structure, but as an ongoing process of adjustment and refinement. 

Subsequent conversations on the CFHA listserv reinforced this perspective. Members asked practical questions: What are we trying to accomplish? What resources are available? How can care be designed for the needs of a particular community? The discussion suggested that models may be most useful when they provide structure without preventing local adaptation. 

Taken together, these discussions pointed toward a field becoming less focused on distinguishing among models and more focused on creating the conditions in which integrated care can succeed. 

Seizing the Moment

As my plane landed, I found myself thinking about how to sustain the momentum and carry forward some of the ideas presented.

Adapted from the Start-Stop-Continue reflection exercise, these four prompts could help teams translate conference learning into action: What should we start, stop, strengthen, and select for focused attention? I offer an example for each prompt to illustrate the exercise.

Start 

What is one new practice we could begin or support? 

• Pilot a brief intervention for a common presenting concern. 

Stop 

What assumption or workflow may no longer serve us? 

• Implementing workflows without defining how success will be measured. 

Strengthen 

What are we already doing that could be made more consistent or effective? 

• Onboarding and role clarification for integrated behavioral health clinicians. 

Select 

What could we realistically advance during the next 90 days? 

• One priority: Which idea is most important to advance now? 

• One change: What process or practice will we implement or test? 

• One partner: Who needs to participate? 

• One measure: How will we know whether the change made a difference? 

 The sessions may be over, but the central question remains: What will we do with what we learned?

See you next year in Columbus, Ohio. 

Photo by rawkkim on Unsplash

Disclosure: Microsoft Copilot was used to support the organization and editing of this article. The idea and structure for the article, as well as the reflections, interpretations, and editorial decisions, are the author’s own.