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The goal of the installation stage is to build system capacity which will support the implementation of the new practices at selected sites. Building system capacity requires examining and strengthening the system components and quality features also called implementation drivers, necessary to assure success.

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Another important installation activity is developing a written implementation plan, which addresses expansion and sustainability. Most of the work of this stage is typically done or supervised by the State Leadership Team (SLT).

During this stage initial implementation sites are selected and Implementation Teams are formed at each site. Implementation Teams oversee the implementation process, build communication and feedback loops, prepare trainers /coaches and develop a site plan for putting the new practice in place.