Telling stories from everyday practice, an opportunity to see a bigger picture: a participatory action research project about developing discharge planning Pia Petersson RN 1 , Jane Springett BA(Hons) MA PhD FRGS 1,2 and Kerstin Blomqvist RNs PhD 1 1 School of Health and Society, Kristianstad University College, Kristianstad, Sweden and 2 Health Promotion and Public Health, Liverpool John Moores University, Liverpool, England Correspondence Pia Petersson School of Health and Society Kristianstad University College SE-291 88 Kristianstad, Sweden E-mail: pia.petersson@hkr.se Abstract In spite of laws, rules and routines, findings from Swedish as well as international research show that discharge planning is not a simple matter. There is considerable knowledge about discharge planning, but the quality of the actual process in practice remains poor. With this in mind, a research and developmental health and social care network decided to use participation action research to explore the discharge planning situation in order to generate new ideas for development. This paper reports on the research process and the findings about our enhanced understanding about the discharge planning situation. Story dialogue method was used. The method is based on stories from everyday practice. The stories are used as ‘triggers’ to ask probing questions in a dialogical and structured form. Local theory is developed to help the participants to find solutions for action in the practice. Our findings were that the discharge planning situation could be seen as a system including three interconnected areas: patient participation, practitioners’ competence and organizational support. To reach good quality in discharge planning, all these three issues need to be developed, but not only as routines and forms. Rather, when developing a discharge planning situation, a system where relational aspects such as confidence and continuity are essential and thus needs to be considered. To achieve a change, the core problem needs to be clarified. When the issue is complex, the solution needs to consider the bigger picture and not just the parts. Telling stories from everyday practice, and to systematically reflect and analyse those in interprofessional groups can create opportunities for enhanced understanding, as well as be a vehicle for future change of practice. Keywords: discharge planning, participatory action research, reflection, story dialogue method Accepted for publication 11 January 2009 Introduction The purpose of discharge planning is to form a plan for patients’ continuing care after being discharged from hospital. Originally, discharge planning was introduced as a way to avoid patients being treated in hospital when not necessary (SFS 1990:1404/2003:193, McGinley et al. 1996, Cummings 1999), as well as being a vehicle for transferring information from one care level to another (SFS 1990:1404/2003:193). Today, there are chiefly two different purposes underpinning discharge planning. One is to transfer both care and budgetary responsibility from the hospital to other agencies for patients who are not in need of in-patient care. Another purpose is to plan for patients’ continuing health and social care. In Swe- den, discharge planning is regulated by a number of laws (SFS 1990:1404/2003:193, SOSFS 2005:27), as well as locally developed rules and routines. In spite of laws, 548 ª 2009 The Authors, Journal compilation ª 2009 Blackwell Publishing Ltd Health and Social Care in the Community (2009) 17(6), 548–556 doi: 10.1111/j.1365-2524.2009.00854.x