Table 1 Themes and illustrative quotes from contradictions

(1) Disagreements across communities

Disagreements across communities

During class, we inform residents that they can ask the attending physician in the discharge planning program for help if they face difficulties with discharge planning for patients. Sometimes, when a resident feels that a patient needs additional help, but the attending physician does not think the same, the resident wonders if they are overthinking and overextending themselves to help their patients. (PGY20)

Disagreements in communication with caregivers

Another challenge in implementation is that sometimes the caregiver, who may not be a family member, may be difficult to reach. The person who should be taught is often absent, which is sometimes rather discouraging. (PGY13)

(2) Subspecialty training

Not providing comprehensive patient care due to subspecialty training

You may want to know the status of a patient after discharge, but there are many others. Sometimes, you move to another department, but the patients in the previous department are still waiting for your follow-up. If you were called two months later, you would not remember how the patient was doing

You won’t necessarily know if a patient is readmitted. Even if you know that they are admitted, they are not under your care, so I think there is a difference. (PGY23)

Residents are only responsible for hospitalization

Residents are only responsible for hospitalization and should focus on medical care. (PGY22)

3) Daily work overload

The patient can be discharged the same day but because you unconsciously postpone this, the patient may already be discharged when you finish priority tasks, or it may be too late in the day. (PGY5)

Residents currently have to take care of these matters, which is too exhausting. The doctor is overwhelmed with the care of the patients. (PGY8)

The implementation of discharge planning by our residents is indeed helpful to the patients, but we still experience it as an overload. (PGY16)