Major trauma discharge from hospital

Being discharged is the process of leaving hospital. It involves making decisions about your rehabilitation and recovery.

How discharge is organised#

Discharge is planned so that you have appropriate care once you leave hospital. Before you go, your healthcare team should talk with you about your discharge plan.

The most common options are to be discharged home under the care of your own doctor, or to be transferred to a rehabilitation centre.

If you are going home, make sure you are registered with a doctor. You may need their help and advice once you are home, at least for the first few weeks.

Some people feel unprepared to leave hospital and begin the next phase of recovery. Your healthcare team is there to support you with advice and information to make the transition as smooth as possible. It is important that you are involved in the decisions about your discharge.

Planning your discharge#

Hospital staff will work with you on a plan for your discharge, recovery, rehabilitation and ongoing care. This is a good time to ask questions and raise any concerns you, your family, carer or friends may have.

When speaking with hospital staff about your discharge:

• Make sure you understand everything you need to do before leaving — this might include going over your discharge plan, arranging aids or equipment, or filling a prescription.
• If you are going home, ask about anything that could help you recover there, such as walking aids or home help.
• Take notes, as your discharge plan may not be written down. Ask questions until you have all the information you need.
• Ask what activities you can and can’t do at home, such as lifting, driving and climbing stairs.
• Understand the warning signs that mean you should call a healthcare professional or return to hospital.
• Check whether you need any follow-up appointments with a healthcare professional or outpatient clinic.
• Record appointment dates in your phone or diary, along with any special instructions (for example, not eating before a blood test).

If you feel too unwell or cannot fully understand what is being discussed, let your medical or other healthcare team know.

You can ask for a support person — such as a family member, friend or hospital social worker — to attend discussions about your discharge. They could take notes, ask questions on your behalf or request further information. Many hospitals also provide patient handbooks, brochures or online information that can help.

Questions you might ask#

During the discharge process, your team will identify the medications and ongoing care you should continue until your next appointment, and who to call if you need help or advice. Questions you might want to ask include:

• I’m worried I can’t take in all this information — how can I make sure I don’t miss something important?
• If I need to ask questions later, who can I contact?
• Will I need any equipment, such as a wheelchair or walker, and do I have to pay for it?
• If pain is a problem after hours, is help available?
• Who can help me if I am feeling overly stressed or anxious?
• How do I work out what treatment I should have once I’m out of hospital?
• How can I prepare my home for my return?
• What are my healthcare rights and responsibilities?

Forms and payment before leaving#

Before leaving hospital, make sure you:

• Complete all the forms and documents you need to.
• Pick up any prescription medication to take with you.
• Arrange payment for any services or products that are not covered by your insurance or any compensation scheme that applies to you.

Costs can vary depending on where you live and your cover. Examples of things you might have to pay for include non-emergency patient transport, pharmacy items, or aids supplied for use at home (such as a raised toilet seat or a splint).

Medication information#

If you have any questions about your medication, discuss them with the hospital staff, and ideally a pharmacist. Consider the following:

• Make sure you know what prescription or over-the-counter medication has been prescribed.
• Check the dosages and instructions for taking them.
• Ask how long you are expected to stay on the medication, and when it should be reviewed.
• Fill any prescriptions you need to take home.
• Tell staff what medications, vitamins or supplements you took before admission, and ask whether you should continue them.
• Write down the name and phone number of someone to call if you have questions about your medication.

If you don’t feel ready to leave#

You may feel you are not ready to go home when you are told it is time, perhaps because you do not feel strong enough, mentally or physically. Speak to your healthcare professional or hospital social worker about your concerns. There are many options for support at home and programs to help you transition from hospital to home.

If you want to leave earlier#

You might want to leave before your healthcare professional says you are ready. It is your choice to refuse treatment at any time and go home whenever you wish.

However, if your healthcare professional recommends care that is only available in hospital, take this into account when planning the services you may need. In some cases you can talk through your concerns and find a way to return home safely with extra support.

Giving feedback#

If you would like to give feedback about your care before you leave, you can speak with the nurse in charge of your ward. If you have a problem with your care, you can also speak with the hospital’s patient liaison officer.

Organising transport home#

If a family member is picking you up, make sure they know what time you will be discharged and whether you need anything for the trip, such as a soft cushion to sit on. If you have to travel a long distance for specialist care, ask hospital staff whether any travel or accommodation assistance is available to you.

Support at home after major trauma#

After a major trauma, many people need short-term or ongoing support after discharge. This may be community based, or provided by your family or carer.

If you live alone and have acquired a short-term or permanent disability, make a plan with your healthcare provider to work out what support you need, how to access it and whether you will need to pay for it. Supports you might need include:

• Access at your home — such as ramps or rails.
• Mobility aids — such as a wheelchair or crutches.
• Help with bathing, or access to the shower or bath.
• Help with driving or transport, including car modifications.
• Help getting medications, especially if you live in a remote area.
• Access to other specialist healthcare services.
• Shopping for food and home cleaning services.
• Contact numbers in case you have questions or need help late at night.

Your hospital healthcare team will usually arrange any support programs you need on discharge. If you need aids and equipment, these have to be organised ahead of time. A wide range of support networks is also available, from social and peer support (such as online and in-person support groups) through to condition-specific support organisations.

Family and carer support#

If you have family or carer support, your discharge planning should include speaking with them before you leave hospital, so everyone is clear about the help you need and want and what they can do.

Make sure you and your family or carer understand any special instructions, such as giving medication or changing bandages. Your healthcare professional can show you how to do these tasks. If you will need extra help at home, organise who will do this, and explain any instructions they need — or ask them to speak with your healthcare team directly.

Paying for treatment and support#

Depending on the cause of your injury, you may be eligible for treatment and support services through insurance or a compensation scheme. These can sometimes cover medical treatment, rehabilitation, disability services and practical help such as home services and child care. Discuss the most appropriate treatments with your healthcare team, and check what any scheme you are covered by can pay for.

If recovery isn’t going to plan#

If you feel unwell once you get home, or your recovery is not progressing as expected, arrange to see your specialist earlier than planned, or talk to your doctor.

Rehabilitation services#

A range of rehabilitation services is available, offering different levels of care. Specialist rehabilitation is available for needs such as burns, spinal cord injury, severe acquired brain injury, and paediatric rehabilitation for children.

If your treatment took place at a major trauma service and you need in-patient (admitted) rehabilitation, in most cases you will stay within that health service for your rehabilitation. Every effort will be made to transfer you back to a service closer to home, but this is not always possible, as a nearer service may not have the specialist care or facilities you require.

Key points#

• It is important that you are involved in the decisions about your discharge.
• It is your choice to refuse treatment at any time and go home whenever you wish.
• You may be eligible for treatment and support services through insurance or a compensation scheme.
• This can include medical treatment, rehabilitation, disability services, and practical help such as home services and child care.
• Discuss the most appropriate treatments with your healthcare team.