Three main themes and 12 subthemes emerged from the analysis, describing health care professionals’ experiences in implementing IPC during patient discharge planning. The main themes and subthemes are summarized in Table 2.

Further details of each theme, including supporting categories and illustrative participant quotations, are presented in Figures 1-3, which were generated using NVivo 15 to visualize the thematic structure, and described in the following sections.

Team interaction dynamics played an important role in the discharge planning process and influenced the implementation of IPC. Participation and coordination among different professional groups were described as central to daily collaborative practice. Participants from various professions, including doctors, nurses, pharmacists, and nutritionists, described diverse interaction patterns that shaped how collaboration was formed, maintained, or hindered during discharge planning. These interaction dynamics encompassed leadership, communication, coordination, and social relationships within the health care team. The identified patterns illustrate how team members worked together to support patient discharge planning in routine practice. The structure of the themes, subthemes, and categories related to team interaction dynamics is presented in Figure 2.

Figure 2 presents Theme 2, “team interaction dynamics”, which includes 4 subthemes with associated categories: (1) group leadership, including leadership roles in coordination and communication and weak leadership; (2) coping, including collectively managed challenges and absence of challenges; (3) communication, including mutual trust in team communication and coordination and support for collaboration; and (4) social support, including helping and complementing each other, professional communication and interaction, and interprofessional coordination and collaboration.

Group leadership influenced the effectiveness of collaboration in discharge planning. Participants described leaders as facilitators who initiated meetings, allocated responsibilities, and guided discussions.

Participants described leadership styles characterized by fairness and openness: “Our leader encourages all members to express their opinions” (P3), and “Our leader is wise and willing to listen to all input” (P5). Some participants highlighted emotional control and role modeling by leaders: “Our team leader can maintain harmony, not authoritarianism” (P6), and “Our leader sets an example and supports joint decisions” (P7). Collectively, these narratives underscore leadership that balances authority with inclusivity.

Participants described both the presence and absence of challenges in IPC. Reported barriers included inconsistent evaluation, limited family engagement, and uneven participation across professions: “The challenges exist, especially because there has been no proper evaluation” (P1); “Coordination is a challenge because not all professions are present during joint visits” (P5). Differences in patient contact among professionals were also noted (P3). Some participants reported minimal challenges due to clear standard operating procedures (SOPs) and defined roles: “There are no challenges because all professions already have clear SOPs” (P6).

Participants described communication as occurring primarily through digital platforms, particularly WhatsApp groups: “Communication is carried out via WA groups” (P2, P7, P8, P9). Verbal discussions and documentation were also used to share patient updates: “We routinely inform each other about patient progress” (P1); “I routinely report patient progress to the team via medical records” (P3). Some participants reported communication challenges among new staff unfamiliar with interprofessional communication practices: “There are minor challenges if there are new employees who do not yet understand the ethics or interprofessional communication” (P6). This indicates the need for structured orientation and communication training within multidisciplinary teams.

Participants described social support as contributing to team cohesion. They reported mutual trust, respect, and shared responsibility. As participant 1 stated, “I feel supported by other team members, so I am more confident,” while participant 3 added, “We respect each other; no one feels more important.” Participants also described encouragement and practical support among team members: “My team members always give encouragement and moral support” (P4). Moreover, collective accountability was evident when colleagues substituted for absent members without complaint: “If someone is absent, the team still covers for each other without protesting” (P6); “If someone is absent, the others are ready to change shifts without any problems” (P8).

Organizational support influenced the implementation of IPC in patient discharge planning. Participants described the role of policies, management, resources, information systems, and work culture in shaping collaborative practice. The structure of the themes, subthemes, and categories for organizational support is presented in Figure 3.

Figure 3 presents Theme 3, “organizational support”, consisting of 4 subthemes with associated categories: (1) organizational culture, including existing SOPs and policies with suboptimal implementation and adaptive culture through integrated digital systems; (2) organizational goals, including organizational direction and evaluation, case manager roles, and training and socialization; (3) organizational structure, including availability of time and competence supported by human resources; and (4) organizational environment, including workload coverage, time management, online communication systems, and the role of case managers in supporting IPC.

Participants reported the presence of SOPs and policies supporting discharge planning. However, limited dissemination and inconsistent implementation were noted.

Some participants described the integration of electronic medical records as supporting collaboration. For example, a participant shared, “The new H-1 discharge policy is linked to electronic medical records, making it more transparent” (Participants 3, 5).

Others noted that implementation at the unit level remained inconsistent: “Although management has established procedures, their execution at the ward level still needs improvement” (Participants 2, 5). A formal structure supporting IPC exists, while cultivating a shared culture that translates into consistent, collaborative behavior in daily clinical work remains a challenge.

Participants described management support for collaboration through direction, case management, training, and evaluation.

Some participants highlighted the role of digital systems in monitoring collaboration:

Participants reported that the availability of discharge planning teams and digital tools supported collaboration. Several participants described sufficient time allocation and improved efficiency through electronic systems. A participant shared, “Time is sufficient as long as roles are clear” (Participant 4), while another added, “Using the electronic system saves time compared to manual charting” (Participant 9). However, human resource limitations were also reported: “Time remains a challenge, but we hope things improve with more staff” (Participants 3, 5).

Facilities and digital access were described as adequate: “computers are available” and “nutrition leaflets and counseling are provided” (Participant 2). Participants also described the hospital’s electronic system as structured and role-based: “the IT system supports collaboration” and “access is structured based on role and profession” (Participants 6, 7). In summary, structural elements such as time, facilities, and information systems play a critical role in enabling IPC, although workload distribution and continuity of IPE still require improvement.

Participants generally perceived the work environment as supportive of collaboration: “The work environment supports collaboration and discussion” (Participant 2). Scheduling and coordination challenges were commonly reported. For example, “lack of adherence to schedules affects plans like physiotherapy” and “conflicting rounds and outpatient duties disrupt communication” (Participant 6).

Some participants suggested integrated scheduling and dedicated interprofessional meetings. “More integrated scheduling and dedicated interprofessional meeting time” (Participant 8). While digital systems were viewed as helpful, some participants preferred direct communication: “IT helps, but direct coordination is still more effective” (Participant 7).

Participants also mentioned the need for regular evaluations: “There should be routine meetings and comprehensive evaluations beyond administrative aspects” (Participant 2). Importantly, individual commitment was stated: “Even with full organizational support, without individual commitment, collaboration won’t work” (Participant 9).

Few participants consider IPC to be running optimally. However, the results suggest that organizational improvements, particularly in scheduling, evaluation, and communication, are still needed to sustain collaborative efforts.

Team dynamics revealed the importance of leadership, communication, coping strategies, and social support. While digital platforms facilitated coordination, collaboration quality ultimately depended on leadership consistency, institutional accountability, and cultural readiness.

Inclusive leadership fostered trust, shared accountability, and psychological safety, consistent with Bornman and Louw [29] and Keniston et al [30]. Conversely, inconsistent leadership resulted in fragmented communication and unclear roles, reflecting uneven policy implementation and limited leadership development common in LMICs [5].

Teams faced logistical challenges such as inconsistent participation and fragmented workflows, echoing findings by Nie et al [4]. Clear SOPs and predefined roles mitigated some challenges, aligning with Buljac-Samardzic et al [31]. Persistent hierarchies and uneven enforcement reflected deeper governance barriers, while family involvement occasionally delayed decision-making when authority was unclear [31].

Hybrid communication using WhatsApp, face-to-face meetings, and documentation supported coordination, consistent with Keniston et al [30] and Teuwen et al [32]. However, message overload and unequal participation persisted without shared digital literacy and leadership oversight [21,33-35]. Compared with high-income settings, IPC in Indonesia remains dependent on interpersonal initiative rather than integrated systems [27,34]

Mutual respect, encouragement, and role flexibility strengthened team resilience, consistent with Cadel et al [34]. These findings align with evidence from high-income contexts showing emotional cohesion as a universal driver of IPC effectiveness [35-42].

Digitalization facilitates coordination but does not eliminate hierarchies or policy inconsistencies. Compared with high-income settings, IPC success in Indonesia relies more heavily on interpersonal leadership and local initiative, highlighting the need for aligned policy, leadership development, and collaborative governance.

Organizational support emerged as a prerequisite for sustainable IPC, encompassing culture, goals, structure, and work environment.

Although SOPs and policies exist, uneven dissemination and weak supervision limited consistent implementation. Hierarchical norms continued to shape communication despite digital tools. These findings align with Redzewsky et al [40] and Ishii et al [41], emphasizing that policy without localized integration fails to sustain IPC.

Leadership support through case managers, training, and evaluation facilitated IPC, although the absence of a comprehensive IPC policy remained a barrier. These findings align with Labrague et al [42], who linked supportive environments to improved safety outcomes.

Structural supports such as discharge teams, digital systems, and facilities enhanced IPC efficiency [43-46]. However, workload imbalance and limited IPE persisted [45]. Rawlinson et al [46] emphasized that the success of IPC was strongly influenced by team competencies, including effective communication, clearly defined roles, and consistent organizational support.

Adopting digital systems, such as electronic medical records and the iKame app, streamlines coordination and reduces time burden across professions. However, human resource shortages and compressed work schedules continue to present major barriers. Buljac-Samardzic et al [31] suggested that team structure optimization, including task clarity, adherence to SOPs, and structured time allocation, could alleviate operational barriers to IPC. Digital platforms such as IPPNs and WhatsApp improved responsiveness but remained informally governed, limiting institutional monitoring.

The organizational environment plays a critical role in enabling effective IPC. Factors such as the availability of resources, dedicated time allocation, and structured workflows are essential for fostering a productive collaborative climate. Although digital technologies have been introduced to support interprofessional communication, several structural barriers persist, including noncompliance with schedules, overlapping clinical responsibilities, workload pressure, and a lack of integrated cross-professional scheduling systems. Ginting et al [47] emphasized that while digital tools could facilitate IPC, their effectiveness was limited in the absence of a supportive organizational culture and inclusive leadership.

Beyond systemic factors, individual commitment remains essential to ensure sustainable collaboration. A previous study found that interprofessional trust emerges from the quality and regularity of relationships, individual attitudes, and a supportive organizational culture, and that trust, in turn, enhances communication, coordination, teamwork, and ultimately collaborative outcomes [48]. Similarly, Reeves et al [49] showed that workplaces promoting team reflection and shared evaluation cultivated trust and accountability among professionals.

When compared to high-income settings, where IPC practices are often embedded in digitalized and standardized systems, hospitals in Indonesia face persistent challenges related to uneven digital infrastructure, informal communication channels, and resource limitations. Similar barriers have been observed in other low- and middle-income contexts such as Ethiopia and the Philippines, where digital and managerial gaps hinder consistent IPC outcomes. These contrasts highlight that while policy frameworks may be globally aligned, contextual and resource-based differences shape IPC implementation in diverse health systems [50-54].

These inconsistencies often stem from institutional hierarchies, variable managerial commitment, and uneven digital literacy among professionals, which prevent the full translation of collaborative policies into daily clinical practice [55].