Transition of Care (TOC)
After a stay in hospital or nursing home, it can be a challenge to return to normality at home post-discharge. The first thirty days of that can be extremely difficult, however with our visiting doctors, the transition to life at home can be made much smoother thanks to our Transition of Care service.
Not only do you receive the practical care at home that helps patients adapt back to life in their own space, but complete support though telephone checks and the confidence from knowing help is available at any time it is needed.
The aim throughout the TOC program is to help the patient avoid unnecessary disruption through readmissions and give the patient confidence in their ability to live and progress where they are most comfortable, at home.
Our doctors at home can carry out a broad range of treatments and services, from discharge summary reviews to ongoing healthcare provision. This includes creating effective medication regimes to allow the patient to stay on top of medication requirements, any lab testing or imaging that may be required for health monitoring, and all prescription requirements.
In addition, visiting doctors can advise family and educate them about the patient’s needs, coordinate transport and organize home aide and specialist referrals to ensure that the full care package is in place.
Through our transition of care program, we remove stress and uncertainty, allowing patients to settle at home and build the care structure that will enable them to stay there and avoid disruptive moves.