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Abstract
A research project was carried out to critically explore and analyse what factors in an interdisciplinary/multidisciplinary context inhibited or promoted decision-making for the discharge planning process for patients returning home from an acute hospital in London. This was done through observations, informal interviewing and focus groups held on two wards and with the supported discharge rehabilitation team. Data were analysed and a conceptual framework developed, highlighting the important factors namely: leadership, team working and communication, affected by behaviours, feelings and resources, including environmental as well as personnel resources. Further analysis of the data suggested that leadership, which acted as a nerve centre for pivoting information, orchestrating and representing the team, and ensuring good outcomes were all important for decision-making in discharge planning. Team working, based on sharing, agreeing responsibilities, roles and boundaries, developing trust, learning together were all important factors. The study showed that good team working and leadership are vital to the success of effective discharge planning, but these aspects are rarely investigated and few resources are targeted on improving them.