Health service integration seems a logical and desirable strategy to improve both the efficiency and quality of service delivery. Failure of implementation is common but may not be inevitable. This paper reports on a case study involving structured interviews and focus groups within one health service which has attempted to integrate one area of its acute and community health services. Health service integration was regarded very positively by clinicians and administrators in this case study but the change management process utilised in its implementation was not, suggesting a need for

At the broadest level, salutogenesis refers to an emphasis on the origins of health, as opposed to a predilection with the determinants of disease. Kickbusch urges health promotion professionals to adopt a salutogenic orientation; directing research and practice towards the question of 'what creates health?' This salutogenic study focused on the most pleasant part of the health continuum by asking: (i) what is high level wellness and (ii) how do people attain and maintain this way of being? Semi-structured interviews were conducted with 25 Australian adults who reported a 'high' or 'very high' level of wellness, health and happiness. Participants described what high level wellness meant to them, their wellness journeys, and the things that helped and hindered their wellbeing. This information was coded, compared and crafted into a constructivist grounded theory. Our interpretation of the data suggests that high level wellness is the sense of peace (wellbeing) that comes from knowing, liking and being one's best self. Happy, healthy people seem to attain and maintain this way of being over time, through a series of self-initiated experiential learning cycles. The 'experiential learning theory of high level wellness' links and extends literature on salutogenesis, eudaimonic wellbeing, self-actualization and experiential learning; positioning everyday people as the leaders of their own life-long wellness journeys. It also suggests a new dimension for Antonovsky's salutogenic theory: aspiring, not just adapting. Future research could explore the utility of our approach with a range of populations and professions, progressing towards 'high level wellness for all'.

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