About this resource
A safe discharge depends on more than medical readiness. This checklist helps hospital social workers work through the person's goals and preferences, home situation, informal supports and carer needs, practical arrangements, community services and follow-up, and agree what to do if things do not go to plan.
Purpose
To support safe, person-led discharges by checking psychosocial and practical readiness and planning follow-up.
Who it is for
Primary profession: Social workers. Also relevant for allied health and multidisciplinary teams, community services and case workers.
Client or participant group: Adults being discharged from hospital, their families and carers.
Practice setting: Hospital and subacute social work, working with the multidisciplinary team.
Suggested uses
- Discharge planning conversations
- Multidisciplinary discharge meetings
- Identifying referrals to community services
- Supporting carers through the transition home
Instructions for practitioners
- Start with the person's own goals for going home or to a new setting.
- Work through each section with the person and, with consent, their family or carers.
- Coordinate with the multidisciplinary team on equipment, therapy and medical follow-up.
- Confirm referrals and appointments before discharge.
- Give the person and carers a plain-language summary and contacts.
Accessibility considerations
Use plain language, interpreters and written summaries. Include carers and supporters chosen by the person.
Scope and limitations
A discharge planning aid. It does not replace your hospital's discharge procedures, risk assessment or medical discharge decisions.
Research basis
Case management practice standards describe assessment, planning, coordination, review and planned exits with the person at the centre.
- Case Management Society of Australia and New Zealand. (2013). National standards of practice for case management (3rd ed.). https://www.cmsa.org.au/
What is included
A 3-page printable A4 PDF, including a practitioner notes page with the research basis (version 1.0).
Originality
Original Practitioner Plus content: wording, activity structure, layout and icons were created for this resource. No third-party worksheets, illustrations or text were reproduced.
