Abstract

Transitional care communication events—such as discharge from hospital—are complex and dynamic: impromptu questions are asked and answered, documents are discussed and signed, and health-care professionals and patients with different knowledge must work together to establish understanding. This article examines a set of patient discharge instructions that bear substantial traces of impromptu conversation in the patient discharge communication process and argues that we need to do more to account for such exchanges as a part of the complex information our documentation must coordinate and make accessible for end users.