TABLE 3.

Unifying Themes and Supporting Codes

Theme: Competing priorities of timeliness and thoroughness

Supporting codes

Professional or hospital norms about discharge

Time pressures including early discharge rules

Balancing multiple priorities or responsibilities

Duty hours and off hours including weekends and cross-cover

Theme: Lack of coordination within multidisciplinary discharge team members

Supporting codes

Teamwork including individual roles, communication and coordination between team members

Clinical complexity or specific complexities of the healthcare system

Specific difficulties arranging for follow-up care

Theme: Uncertainty about provider roles and patient readiness for discharge

Supporting codes

Uncertainty about provider roles or discharge timing

Readmissions and “bounce-backs”

Clinical complexity or specific complexities of the healthcare system

Theme: Lack of standardization in discharge procedures

Supporting codes

Teamwork

Readmissions and “bounce-backs”

Patient safety including the concept of “safe discharge” and mistakes or errors

Clinical complexity or specific complexities of the healthcare system

Checklists or other specific procedures/aids or “clever systems” to improve quality

Discharge documentation

Theme: Poor patient communication and postdischarge continuity of care

Supporting codes

Lack of continuity of care after discharge

Specific difficulties arranging for follow-up care

Information technology including electronic medical records

Patient communication, education, or understanding

Discharge documentation