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BACKGROUND: Youth health issues represent a "wicked problem" – they are complex and multifaceted. Furthermore, they are likely to require novel approaches to understand their complexity and develop novel solutions. OBJECTIVE: Given the importance of youth healthcare, and the need for novel approaches, the aim of this article was to demonstrate the innovative use of two research methods – thematic and lexical analyses – to better understand practitioner perspectives of youth healthcare. It clarifies the factors that shape practitioner ability to support young people and opportunities to improve practice. DESIGN AND SETTING: Focus groups and interviews were conducted with 37 youth health practitioners. They represented government and non‐government services; hospital and community services; and metropolitan and regional services. RESULTS: Thematic analysis highlighted the complexity of participants' work and the judgements made as they negotiated relationships with young people and ancillary services. Lexical analysis revealed two hitherto neglected dimensions of the complexity of youth healthcare – uncertainty and corporeality. DISCUSSION: In addition to affirming the complexities of youth healthcare, this study revealed how practitioners (can) negotiate these complexities. These findings were only possible because of the innovative use of the two research methods. CONCLUSIONS: This study has important theoretical, methodological and practical implications. Theoretically, it is the first to view the complexities of youth healthcare through the wicked problem lens. Methodologically, it highlights the complementary value of thematic and lexical analyses. Practically, it reinforces the importance of policy support and professional development to enable practitioners to grasp the complexities of their work.

Recent Australian research suggests that professional boundaries are not necessarily bounded and static, but reconstituted in response to reform. An examination of professional identities within the healthcare sector suggests that societal and political change serve to liquefy professional delineations. Yet, how do these changes affect traditional labour divisions; and how do the forces for change affect the reconstruction of professional identity? This paper demonstrates that organisational pressures are changing the historically anchored medical profession and the emerging nursing profession. Such change is also influenced by the void between clinicians cum managers and clinicians. Because the success of healthcare reform is contingent on professional interdependence, it is important that the evolution of professional delineations within the sector is understood.

Background: Youth health issues represent a "wicked problem" – they are complex and multifaceted. Furthermore, they are likely to require novel approaches to understand their complexity and develop novel solutions. Objective: Given the importance of youth healthcare, and the need for novel approaches, the aim of this article was to demonstrate the innovative use of two research methods – thematic and lexical analyses – to better understand practitioner perspectives of youth healthcare. It clarifies the factors that shape practitioner ability to support young people and opportunities to improve practice. Design and Setting: Focus groups and interviews were conducted with 37 youth health practitioners. They represented government and non‐government services; hospital and community services; and metropolitan and regional services. Results: Thematic analysis highlighted the complexity of participants' work and the judgements made as they negotiated relationships with young people and ancillary services. Lexical analysis revealed two hitherto neglected dimensions of the complexity of youth healthcare – uncertainty and corporeality. Discussion: In addition to affirming the complexities of youth healthcare, this study revealed how practitioners (can) negotiate these complexities. These findings were only possible because of the innovative use of the two research methods. Conclusions: This study has important theoretical, methodological and practical implications. Theoretically, it is the first to view the complexities of youth healthcare through the wicked problem lens. Methodologically, it highlights the complementary value of thematic and lexical analyses. Practically, it reinforces the importance of policy support and professional development to enable practitioners to grasp the complexities of their work.

Scholars studying emotions in social life typically work mono-logically, within a paradigmatic camp, drawing on distinct theories of emotion. In isolation, each offers a singular conceptualisation of emotions in social life. Working multi-logically, in contrast, offers richer, comparative insight into the layered meanings of emotion relevant to a social context. Rather than treating them as incommensurate, we not only argue for the benefits of drawing on multiple paradigms, methods and theories of emotions in social life, we offer a worked example of a post-paradigmatic methodology for analysing emotions in social life that values multi-logicality and epistemic flexibility. Setting aside debates about what emotions are, we work from the premise that different conceptualisations of emotions do things: shape what we see and ignore, and discursively position people. We show how multiple theories and concordant methods can – and should – be applied to studying emotions in social life in the same study. In this empirical illustration of a methodological innovation, we map theories and methodologies of emotions in social life against four research paradigms and against four phases of a study into the emotional dimensions of interprofessional practice, depicting the realisations afforded through a post-paradigmatic methodology for analysing emotions in social life.

Brilliance has been overlooked in studies of professional work. This study aimed to understand how brilliant practices are made possible and enacted in a multidisciplinary paediatric feeding clinic, where professionals from different disciplines work together and with parents and carers of children. The existing literature has thematically described brilliance but not theorised how it is accomplished and enabled. Using video reflexive ethnographic methods, the study involved the video-recording of 17 appointments and two reflexive discussions with the participating professionals, who selected and reviewed five episodes exemplifying brilliant care. These were analysed through three themes: carer-friendly and carer-oriented practice; ways of working together; and problem-solving in actu (in the very act of doing). Using the theory of practice architectures, we explored brilliant practices as complexes of sayings, doings, and relatings, identifying the arrangements that enabled those practices and the forms of praxis involved.

Purpose
– The purpose of this paper is to present a business process reengineering (BPR) framework of process and data integration with patient journey as the basis for process evaluation and the improvement of patient-flow.


Design/methodology/approach
– A BPR framework is developed using a mixed-method research design, which incorporated a case study to demonstrate a healthcare scenario with associated processes and data elements, using process models based on event-driven process chain methodology as well as patient and data models, based on unitary structuring technique. The framework includes key processes including patient booking and rebooking, and associated inputs, outputs, and control parameters. In this case, the framework is demonstrated through application to computed tomography (CT) services in a hospital to improve patient-flow, with numerical simulation of CT data collected over time.


Findings
– The framework supports flexible patient scheduling and the associated planning of healthcare operations and logistics – this in turn helps to improve patient-flow. Furthermore, mathematical modelling and simulation precisely reveal the impact of booking and rebooking on the performance of the CT department.


Research limitations/implications
– This innovative framework has potential value for other services, within and beyond the hospital setting.


Originality/value
– The proposed framework of process modelling, data, and patient journey addresses the lack of a holistic approach to monitoring and evaluating service performance in hospital settings. Patient journey modelling is an integral part of process and data models that can be implemented in an integrated system environment such as an enterprise resource planning system for real-time monitoring of patient-flow under dynamic conditions.

HASI is an innovative program funded by the NSW Government that ensures stable housing linked to a range of levels of specialist support for people with a mental illness. The Social Policy Research Centre (SPRC) of the University of NSW has recently completed a two-year longitudinal evaluation of the first stage of HASI. This report details the outcomes of HASI Stage One, which was implemented in 2003 with 100 places of high-level support in nine locations across NSW. The evaluation by the SPRC has helped to guide the further development of HASI. This is the final Housing and Accommodation Support Initiative (HASI) Stage One evaluation report. HASI is a partnership between NSW Health, the Department of Housing (DoH) and non government organisations (NGOs), and is jointly funded by NSW Health and DoH. The program follows psychosocial rehabilitation principles and has a recovery focus. It aims 'to assist people with mental health problems and disorders requiring accommodation (disability) support to participate in the community, maintain successful tenancies, improve quality of life and most importantly, to assist in the recovery from mental illness' (NSW Health and NSW DoH 2005).

Abstract
As the Australian state of New South Wales considers the adoption of a policy of personalised budgets in child protection, questions arise regarding how such a policy could take shape and how it would impact service delivery to promote safety and well-being amongst vulnerable children. This article presents findings from a mixed-method, realist evaluation of a pilot programme that adopted some of the features of personalised budgets, namely, personalisation, brokerage and keyworkers. Drawing on literature on personalised budgets in disability and aged care, the article highlights the features, potential benefits and challenges of personalised budgets in child protection. It concludes by arguing for a better understanding of how personalised budgets could benefit vulnerable children. This might involve: defining the roles of brokers and keyworkers, developing ways to increase service user engagement, clarifying implications for the wider service sector and planning for the provision of required supports and services for children and families.

This report presents the summary findings of the second phase of a longitudinal evaluation of the Housing and Accommodation Support Initiative Stage One (HASI) from May to October 2005. HASI is jointly funded by NSW Health and the NSW Department of Housing (DoH). A three-way partnership between the two government departments and non-government organisations (NGOs), 'HASI is designed to assist people with mental health problems and disorders requiring accommodation (disability) support to participate in the community, maintain successful tenancies, improve quality of life and most importantly to assist in the recovery from mental illness'.1 This evaluation is based upon qualitative and quantitative data collected from 205 stakeholders, including clients (n=79), housing providers and Area Mental Health Service (AMHS) and Accommodation Support Provider (ASP) personnel. The complete version of the second report will be publicly available soon. This report should be read in conjunction with the first evaluation report (Morris et al 2005).