Discharge Planning from Hospital to Home
Preparing for yourself or for a loved one to be discharged from the hospital can feel confusing and overwhelming. THP is committed to regular communication to help with the discharge planning process and it is important for patients, families and/or Substitute Decision Makers (SDM) to be available and involved in these conversations as key partners the planning process. Be sure to connect with your healthcare team early on to get information about your plan of care and anticipated discharge date. Before your discharge, be sure to ask questions about what will be needed for your safe journey home and anything else you may require for your recovery. If homecare or other supports are needed, a care team will arrange this before you leave the hospital. Ask for clarification if there is something that you don’t understand. Use the staff and resources you have in the hospital to address any concerns. Your healthcare team is there to assist and support you. Follow up with your family doctor once at home, as they are your resource in the community.
Transitioning from hospital to a new health care setting
When you are ready for care beyond the hospital setting, THP follows a standard process to ensure your care needs are met and continuous care is provided as you transition out of the hospital. This involves working with you, your family and/or your Substitute Decision Maker (SDM). THP explores all opportunities available to determine the most appropriate place for a patient to transition and takes into consideration one’s specific care needs, financial situation, home community and more. These are all factors that will be discussed with you and/or your family or SDM through ongoing conversations and touchpoints. Various community settings are available to a patient, such as retirement homes, group homes, long-term care or transitional care such as the Reactivation Care Centre (RCC). Rest assured, THP will not discharge a patient who requires additional care in a specialized setting without a proper care plan and supports in place.
Funding for this project was generously provided by the Province of Ontario.
The views expressed in this publication are the views of Trillium Health Partners and do not necessarily reflect those of the Province.
