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This paper discusses methodological challenges in researching practice. The primary challenge discussed arises from the view that practice is inextricable from its performance, and that performance is embedded in social relations, material infrastructures and historical context. The paper argues for a philosophical hermeneutics approach that works with practitioner-informants to explicate a model of variables salient to practitioners, which, in concert, would support practical wisdom in decision-making. A further methodological challenge discussed in the paper is that of defining the object of practice. The paper argues for avoiding tight definitions in favour of discovering from the lived experience of informants a recognisable 'family likeness' in relation to the object of practice. The paper shows how one research team responded to the challenges by its choices of stance, lenses through which to attend to information, selection of sources, and how to discern and present emergent insights.

The language of co-creation has become popular with policy makers, researchers and consultants wanting to support evidence-based change. However, there is little agreement about what features a research or consultancy project must have for peers to recognise the project as co-creative, and therefore for it to contribute to the growing body of practice and theory under that heading. This means that scholars and practitioners do not have a shared basis for critical reflection, improving practice and debating ethics, legitimacy and quality. While seeking to avoid any premature defining of orthodoxy, this article offers a framework to support researchers and practitioners in discussing the boundaries and the features that are beginning to characterise a particular discourse, such as the one that is unfolding around the concept of co-creation. The paper is the outcome of an online and face-to-face dialogue among an international group of scholars. The dialogue draws on Critical Systems Heuristics' (Ulrich, 1994) questions concerning motivation (revealing assumptions about its purpose and value), power (interrogating assumptions about who has control and is therefore able to define success), knowledge (surfacing assumptions about experience and expertise) and legitimacy (disclosing moral assumptions). The paper ends by suggesting important areas for further exploration to contribute to the emerging discourse of co-creation in ways that support critical reflection, improved practice, and provide a basis for debating ethics and quality.

For the past decade, collaboration has been the preferred method of devising land and water policy in Aotearoa New Zealand to achieve agreed outcomes. However, the use of collaboration in policymaking is at a crossroads, as some argue it is unrealistic to expect stakeholders and tangata whenua with competing interests to work in partnership on contentious policy issues. To help clarify the future direction of collaboration, this paper provides authorising agencies (those with responsibility for the policy problems) with prompts to reflect ex ante on the advantages and disadvantages of pursuing collaboration. Based on a retrospective review of collaborations in New Zealand's land and water policymaking, and a two-day symposium with collaboration practitioners, we identify situations that are potentially less suited to collaboration owing to factors that are challenging to overcome through process design. Four issues that affect the success of collaborations are identified: the nature of the policy problem, the personal and collective qualities of those involved, power relationships, and the collaborative process. Finally, we draw together practical lessons from history, the symposium, and the literature to develop a list of questions for authorising agencies to use to reflect on the advantages and disadvantages of pursuing collaboration. [ABSTRACT FROM AUTHOR]

In systemic intervention, boundary critique is important. This means explicitly exploring the inclusion, exclusion and marginalization of both people and issues. Most of the practitioner's attention in boundary critique is usually focused on relationships between stakeholders (i.e. the participants in the intervention and those who might be affected by it). A significant focus is also the remit of the intervention: those things that need to be directly addressed or bracketed out in order to make a difference that is meaningful to a broad range of stakeholders. What is often less visible during boundary critique is the personal and/or professional identity of the practitioner, and the impact this may have on both relationships with others and the construction of people's understanding of the issues they are grappling with. This paper reflects on a project promoting environmental health through Maori community development that reveals the importance of personal and professional identity to systemic intervention. It is argued that it is impossible for practitioners to set aside their identities and become 'neutral' modellers or process facilitators. When this appears to happen it is because the practitioner's identity has been (often invisibly) constructed to legitimate his or her activities, and these activities do not transgress the expectations of participants that flow from their understanding of the practitioner's identity and role. Nevertheless, even though practitioner identities inevitably impact on the trajectory of interventions, at least some of their implications can be explicitly acknowledged and managed as part of systemic intervention. Some examples of management strategies are provided. Keywords boundary critique; environmental health; identity; Maori community development; systemic intervention, INTRODUCTION Over the past 40 years, a number of authors have argued that it is important to investigate the boundaries of systemic interventions (e.g. Churchman, 1970; Jones, 1982; Ulrich, 1983, [...]

While lean thinking has been used in healthcare for almost two decades, its efficacy has been debated extensively by researchers and practitioners alike. This ongoing debate is largely due to the varied results of its implementation; and resistance to change is considered to be the primary reason behind this variation. This study adopts an institutional logics perspective to analyze the nature of this resistance by drawing attention to how clinical staff make judgements about the appropriateness, acceptability and legitimacy of lean thinking. To conceptualize resistance, a systematic literature review based on 33 published studies depicting lean implementations was conducted, which helped to develop a nuanced understanding of resistance and its causes. Subsequently, 47 semi-structured interviews were undertaken with Quality Improvement managers regarding their experience with implementing lean thinking in 15 New Zealand District Health Boards. These interviews were used to identify and evaluate strategies used to minimize resistance within the implementation of lean initiatives in healthcare organizations. The findings of this research suggest that typically there are three strategies adopted by quality improvement managers—(1) communication strategies to create a better narrative for lean implementation; (2) cooperation strategies, which encourage the adherents of lean and medical logics to work together on shared problems, creating opportunities for them to learn about other logics; and (3) performance management strategies with the help of incentives and commitment devices to create a supportive environment for lean implementation. Together, these strategies work to improve the availability, accessibility, and activation of lean thinking logic in healthcare. [ABSTRACT FROM AUTHOR]

Health inequities among Indigenous and non-Indigenous communities are well documented and the research literature includes robust discussions about innovative ways to reduce inequities including co-design. Co-designing health promotion interventions with Indigenous communities presents many benefits and challenges for researchers, health professionals and communities involved in the process. The purpose of this study was to identify the facilitators and barriers of co-designing a health promotion intervention with Māori communities. Additionally, this study considers a specific Māori co-design framework, He Pikinga Waiora (HPW). HPW is a participatory approach to creating interventions emphasizing community engagement, systems thinking and centred on Kaupapa Māori (an approach grounded in Māori worldviews). The research design for this study was Kaupapa Māori. Participants (n  = 19) in this study were stakeholders in the New Zealand health sector. Participants were interviewed using an in-depth, semi-structured protocol. Thematic analysis was employed to analyse the data. Facilitators for co-designing health promotion interventions with Māori communities were collaboration and community voice. Barriers identified were mismanaged expectations and research constraints. Finally, facilitators for the HPW framework included providing clear guidelines and being grounded in Māori perspectives, while barriers included limited concrete case studies, jargon and questions about sustainability. Collaboration and inclusion of community voice supports the development of more effective co-design health promotion interventions within Māori communities which may address health inequities. The HPW framework offers clear guidelines and Māori perspectives which may assist in the development of effective co-design health promotion interventions, although areas for improvement were suggested. [ABSTRACT FROM AUTHOR]