The document discusses several key design issues in entity-relationship (ER) database schemas including:
1) Distinguishing between entities and attributes and how they are modeled, such as whether a phone number is an attribute of employees or its own entity.
2) Modeling relationships between entities as either binary or ternary relationships and how ternary relationships can be broken down into multiple binary relationships.
3) Relationship design considerations like whether a relationship such as an employee working in a department should allow for multiple time periods or just one.