Table 4.

Exemplar quotes related to staff involved in discharge procedures.

Key issues	Exemplar quotes
Staff shortages and high workload	“If our workload is heavy, there is the possibility with the steps that we have for us to miss medication, to input directions incorrectly or to not cease a medication – like not communicating the ceasing of a medication just purely based on time I would say if that stuff is not documented.” —P 2.
Communication with other healthcare clinicians	“If they [discharge nurses] have got a system on that particular ward [where] they tell the doctors straightaway that they need prescriptions, [and] the more they tell the doctors that, the more the doctors will do it before they have to get told and berated. So, the good ones are good at actually instituting that. As soon as the doctors start on their rotations, [they make it known that] these are the expectations. The pharmacist should be trying to do that as well, but obviously, it helps if the discharge coordinator is doing that… then it's not on us to be saying constantly ‘can you please do the discharge rec, can you please do prescriptions.’ They have already had that droned into them by the discharge coordinator.” – P 10. “I think for me, what's difficult is I work with at least five different medical teams. Those medical teams work across multiple wards in the hospital. So, they're often not on my ward. Which means I often can't find them to discuss things. It relies on me ringing them. Which means I'm probably interrupting them. Which means the chances of me getting their full attention might be reduced, because they're in the middle of a ward round, or concentrating on another patient, or answering someone else's queries. I always find phone conversations a bit more difficult to ensure that the person's giving me full attention, versus face-to-face.” – P 8.
Increased utilisation of pharmacy assistants	“Swiss cheese rule, if you have someone else do something you're more likely to pick up a mistake because you haven't looked at it 10 times.” – P 3. “If they [pharmacy assistants] are involved in more admission history taking, having more admissions histories available speeds up the discharge process, because you have an accurate starting record. As well, for that reason, the treating team can make hopefully, better decisions of care because they're making choices based on better information, because they have admission medications there… On the same basis, if clinical assistants, if once all of the histories are taken, and they're assisting with discharges, if they're entering all of those PAHNs [Pharmacist Admission History Notes] into eLMS, so we've got our starting list, again, that's just another fairly extensive step that's taken off the pharmacist, that would definitely speed things up as well.” – P 6.
Staffing considerations in specialist areas	“Our biggest challenge right now, as I said, with the pharmacists is that they can't be physically present on the unit, so for us, the staffing would have to be increased to be more present than we are at the moment, As much as possible, I try and get them to be present at the case reviews, because the staff sees them, they put a face to the name, there's an excellent opportunity to ask questions and interact.” – P 12.