This study employs stroke rehabilitation in hospitals as a case study in order to clarify a range of practical organizational concerns and conceptual issues related to decision making in complex organizations. The author identifies the strengths of "classical" ethnomethodology, considered separate to its contemporary interpretations in both social studies of science and conversation analysis. The book's analytical framework is cognate with both management science and interactionist sociology, and is specifically tailored to the study of how decisions actually get made by professionals in bureaucratic institutions. Data are examined to address two key questions: how are different professional and individual perspectives reconciled in meetings? and how are formal management tools (policies, protocols, practice standards) used in situ?