Systemic reform refers to changes that are made across an entire system or organization, with the aim of improving its overall functioning and effectiveness. This can involve alterations in policies, procedures, structures, and practices within the system, as well as changes in attitudes and behaviors among those who work within it. The goal is often to address deep-seated problems or issues that have been identified, with the aim of bringing about long-term, sustainable improvements. Systemic reform can take place at various levels - from small scale changes within a single organization, to large-scale reforms affecting entire sectors or industries. It requires careful planning and implementation, as well as buy-in from all stakeholders involved.