Safe Transitions of Care

1
Safe Transitions of Care

• Transition planning begins upon admission and is
  a joint effort with the patient, his/her family,
  the clinician and hospital care team.
• Reassessment of the patients needs continues
  throughout hospitalization.
• Care and treatment instructions are provided to
  the patient upon discharge, to be followed at
  home or at the accepting agency.
• Follow-up phone calls may be made by OMC staff to
  the patient after discharge.
• Follow-up appointments for patients should be
  made by OMC staff prior to patients discharge
• Please see Discharge Planning and Referral Policy
  and Procedure for further details