https://text.npr.org/137002727

They need to change this so that at least all legal costs have to be paid while appeal is pending, then if the appeal succeeds, they have to pay it back.

Then the state may have some time period to allow the the losing party to pay. If they have still not done so, the winning party can petition for a writ of execution, which allows you to take the judgment which is basically a floating lein, and attach it to specific property of the debtor. The property can then be levied, garnished, or foreclosed upon, usually with the help of the exeutive.

Attaching to real property is often fraught, because the forclosure process is complicated, and plenty of real property will have other liens on it, for example from a mortgage. This makes forclosing much more complicated.

Levies against "personal property" (chattel) can be somewhat easier, with the sheriff seizing the property, selling it at public auction, and giving you the proceeds up the the judgment amount and interest, and giving the rest back to the debtor. But while cool sounding, this is often fairly impractical due to the fact that a lot of chattel property has little value (or at least will get little money at auction), and the property worth substantial money is more likely to be leased, or subject to a loan, or other similar complications.

Attaching to and garnishing funds from a bank aaccount, or levying other intangible assets may be the easiest approach, especially for an organization like the college. For example attaching to the stocks/bonds etc that make up the colledge endowment would be able to recover this judgment without issue. (although attaching to intangible assets may be more complicated than physical assets, depending on state laws.)

Realistically, the moment you start trying to do any of this, the other party (if solvent and able to pay) will often suddenly be more than happy to just give you the money. (It turns out to be much cheaper and easier for them that way).