Why discharge medication communication matters
Hospital discharge is a high‑risk moment for patients. New prescriptions, changed doses, time pressure, and fragmented handovers can leave people unclear about what to take, when to take it, and who to call when something goes wrong. That uncertainty is not trivial: it can translate into medication errors, adverse events, and avoidable re-presentations.
A ‘black box’ worth opening
In the IJQHC Seminar Series panel discussion, Professor Reece Hinchcliff (Deputy Editor, International Journal for Quality in Health Care; ISQua) framed a question many quality and safety researchers recognise: complex real‑world studies look elegant on paper, but what did it take to actually deliver them inside busy health systems?
This session set out to unpack that black box by spotlighting the Reizenstein Award-winning paper, “Co‑design of an intervention to improve patient participation in discharge medication communication,” and letting the team tell the story behind the study.
Where the CHAT Study began
The CHAT Study started with frontline realities. As pharmacist Trudy Teasdale described, discharge is often fast, pressured, and information‑dense. Patients are ready to leave; clinicians are balancing competing demands; and medication communication can become last‑minute and one‑directional. The team’s starting point was simple: if patients and families do not understand discharge medicines, safety is compromised.
Doing the groundwork before building the solution
A standout feature of the CHAT program was that the team did not jump straight to designing an intervention. Professor Elizabeth Manias explained that the group first built a robust evidence base through a systematic review alongside observations, surveys, and patient interviews. That early work confirmed a consistent pattern: patients wanted to participate in discharge medication discussions, but often lacked the confidence, opportunity, or prompts to ask questions. Families were frequently under-involved, and communication could default to a ‘telling’ model rather than a collaborative conversation.
Co-design that stayed authentic
The heart of the CHAT Study was genuine co‑design. Georgia Tobiano described a multidisciplinary structure with a consumer-inclusive co‑design group (consumers, pharmacists, nurses, and doctors), a leadership group to safeguard feasibility, and a research team to translate insights into a practical intervention.
Health consumer Lucy Lai anchored the work in lived experience, including the needs of culturally and linguistically diverse patients and families. She helped simplify language, shape the digital resources and question prompts, and advocate for accessibility and translation. Her message captured the intent of the intervention: helping patients leave the hospital carrying confidence rather than confusion.
What the intervention actually looked like
The final intervention was simple in appearance but carefully engineered in function. It combined a bedside poster and a take‑home brochure with three QR codes, each linking to a distinct support resource:
- Learn More: consumer‑friendly medication information in plain language
- Ask Questions: a question builder that helps patients select what matters to them, then sends prompts via SMS or email
- After Discharge Support: post‑discharge resources such as medication hotlines and apps
The design goal was straightforward: make it easier for patients to understand, ask, and follow up.
Feasibility, acceptability, and why ‘simple’ interventions can be complex
Professor Andrea Marshall emphasised an important nuance: even when an intervention looks simple at the point of care, the underlying system work can be complex. CHAT is multi‑component and targets multiple users (patients, families, clinicians), which raises the bar for implementation and evaluation.
A key strength was the staged approach to development: testing and refining early, clarifying what works, for whom, and why, before scaling. The panel also addressed a common concern about technology and older patient groups. While QR codes might once have been seen as a barrier, widespread use during COVID has increased familiarity, which may support adoption and sustainability.
How a diverse partnership stayed aligned
Complex projects succeed or fail on coordination. Megan Rattray described practical engagement strategies that helped maintain momentum: an up‑front engagement plan, one‑to‑one relationship building, clear communication, materials circulated well in advance, regular updates, and flexibility to match partner preferences.
Kelly Ren added a point that resonates across health services: research participation does not have to be ‘all or nothing’. Even small contributions from busy clinicians can build research culture and keep projects grounded in real workflows, especially when university and health service partnerships are strong.
Three takeaways for quality and safety leaders
1) Start with the real problem. The CHAT team began with frontline pain points and patient experience, then built the evidence base to confirm what needed to change.
2) Treat co‑design as capability, not consultation. Consumers were not token contributors; they shaped language, usability, and accessibility.
3) Develop in stages. Complex interventions need early feasibility and acceptability work to prevent downstream implementation failure.
What’s next
In closing, Georgia Tobiano reflected that future co‑design could be even more creative and interactive, a reminder that participatory methods are still evolving.
If your organisation is grappling with discharge medication communication, the CHAT Study offers a pragmatic template: combine rigorous methods with authentic partnership, then translate insights into tools people will actually use.
Watch the interview here – https://vimeo.com/1163642150/5ad4dac8b1
