Meligonis Christina, Hattingh Laetitia, Alcorn Sean
Griffith University, Australia.
Pharmacy Department, Royal Brisbane and Women's Hospital, Australia.
Health Inf Manag. 2025 Jun 26:18333583251344975. doi: 10.1177/18333583251344975.
Hospital discharge is a vulnerable point in a patient's journey where increased medication-related errors occur. Despite the importance of discharge summaries as a communication tool at the hospital-community healthcare interface, many factors impede doctors' ability to prepare accurate and timely discharge summaries and medication lists. To explore junior doctors' perceptions of the hospital discharge process. Semi-structured interviews were conducted with purposively selected junior doctors (interns, residents and registrars) from a metropolitan health service between November and December 2022. The interview tool contained prompts to explore opinions and experiences relating to the discharge processes, specifically discharge summaries, medication reconciliation and collaboration between healthcare professionals. Interview transcriptions were thematically analysed. Twenty junior doctors were interviewed. Five interconnected themes emerged: (1) workload and time restraints, (2) perceptions of medication reconciliation, (3) collaboration with pharmacists, (4) communication between healthcare professionals and (5) impact of organisational factors. Significant barriers to preparing discharge summaries included time pressures and high patient turnover. Factors aiding doctors included direct involvement in the patient's care, designated time to complete discharge summaries, well-documented in-patient progress notes and availability of comprehensive admission medication information recorded by pharmacists. : Junior doctors face significant challenges during the hospital discharge process. Under heavy workloads and high patient turnover, continuity of care can be compromised as direct patient care tasks take priority over preparing discharge summaries. The findings underscore the need for enhanced medicines education and support for junior doctors, alongside improved integration of pharmacist expertise, to facilitate clear, accurate and timely discharge documentation.
医院出院是患者就医过程中的一个脆弱环节，在此期间与用药相关的错误发生率会增加。尽管出院小结作为医院与社区医疗保健衔接处的沟通工具很重要，但许多因素阻碍了医生准确及时地编写出院小结和用药清单。为了探究初级医生对医院出院流程的看法，于2022年11月至12月对从一家大都市医疗服务机构中特意挑选的初级医生（实习生、住院医师和专科住院医师）进行了半结构式访谈。访谈工具包含一些提示，以探讨与出院流程相关的意见和经历，特别是出院小结、用药核对以及医疗保健专业人员之间的协作。对访谈记录进行了主题分析。共访谈了20名初级医生。出现了五个相互关联的主题：（1）工作量和时间限制，（2）对用药核对的看法，（3）与药剂师的协作，（4）医疗保健专业人员之间的沟通，以及（5）组织因素的影响。编写出院小结的重大障碍包括时间压力和高患者周转率。有助于医生的因素包括直接参与患者护理、有指定时间完成出院小结、住院病程记录完善以及药剂师记录的全面入院用药信息可用。初级医生在医院出院过程中面临重大挑战。在繁重的工作量和高患者周转率情况下，由于直接的患者护理任务优先于编写出院小结，护理的连续性可能会受到影响。研究结果强调需要加强对初级医生的药物治疗教育和支持，同时更好地整合药剂师的专业知识，以促进清晰、准确和及时的出院文件记录。
