Preparing the home before leaving hospital

Documents to keep at hand

The discharge prescription, the hospital report, the Carte Vitale and the top-up insurance certificate are enough to start care.

A missing prescription does not block the first visit: we call the ward or the GP. But it costs time that could have gone into care.

Equipment delivered by the provider

Hospital bed, pressure-relieving mattress, drip stand, walking frame: delivery is often scheduled for discharge day, sometimes later. Check the stated time.

Prescribed dressings, syringes and compresses should be collected from the pharmacy before the first visit. We do not carry stock on a patient's behalf.

Making the home workable

An accessible water point, decent lighting in the room where care will take place, and a clean surface for equipment are enough.

Clearing the path to the bed, removing slippery rugs and providing a stable chair markedly reduce fall risk in the first days.

The forty-eight hours before discharge

A discharge is rarely decided on the day: it is decided two days earlier, when the ward announces a date. That is when to call the practice, the pharmacy and the equipment supplier, in that order.

We then confirm that the first visit is feasible, its approximate time and the exact list of what must be at home. A refusal for lack of capacity is known at that point, not on the evening of discharge.

If an anticoagulant is started in hospital, ask the ward for the monitoring schedule: the first blood test, often an INR check, frequently falls within three days of the return home.

Relatives: what to ask of them, and what not to

A relative can prepare the room, handle deliveries, keep the visit calendar and hold the access codes. That is already considerable, and it genuinely changes the first days.

A relative should not perform technical care, judge a wound or adjust a treatment. Confusing help with care exhausts families and delays useful alerts.

We leave a single sheet at home with the numbers to call, the visit times and the signs that justify not waiting for the next one.

What we check at the first visit

That the discharge prescription matches the medicines actually present at home.

That the person and their relatives understand the treatment.

Vital signs, pain, and the state of the scar or puncture site if there is one.

Who does what, from the ward to the first visit

A discharge never rests on one person. It rests on a short chain in which everyone knows what they must produce, and when. When a link is missing, care does not stop — care time turns into telephone time.

The table below describes the split as we experience it locally. It carries no regulatory weight: it tells you who to call when something is stuck.

Three discharge scenarios, and what they change

A planned discharge after elective surgery is the simplest case: the date is known days ahead, equipment arrives in time, the first visit is scheduled without pressure.

An early discharge — the ward frees the bed sooner than planned — is the commonest cause of improvisation. One phone call fixes it: tell us before leaving the hospital, not once you are home.

A discharge after an unplanned stay (emergency, decompensation) needs more checking: usual treatments have often been changed, and the list handed over at discharge is authoritative, not the box left in the drawer.

The day-before checklist

It reads in two minutes and prints on one page. We give it to families who ask, because a prepared home saves a quarter of an hour of care on day one.

• Discharge date and time confirmed by the ward.
• Discharge prescription read: every expected procedure appears on it.
• Pharmacy informed, care supplies collected.
• Heavy equipment delivery confirmed by the supplier.
• Practice called, first visit booked.
• Home access settled: code, key, floor, entryphone.
• Care room cleared, enough light, water point reachable.
• Useful numbers posted: practice, GP, pharmacy, 15.

The day before: seven checks that prevent an emergency call

A discharge rarely fails on the care itself. It fails on what is missing at eight in the evening, when the pharmacy has closed and the ward no longer answers. These seven points take ten minutes to check.

• The discharge prescription is physically at home, not in a file left at the hospital.
• Prescribed supplies (dressings, syringes, compresses) have been delivered and are within reach.
• The bed can be reached from both sides, with a stable support to stand up.
• The path from bed to bathroom is clear and lit at night, with rugs removed.
• A charged phone stays within reach from the bed and from the armchair.
• The current medication list is up to date: the discharge list is authoritative, not the boxes in the drawer.
• A relative or neighbour knows the discharge is happening, and at what time.

What actually helps at home in the first days

In the first days tiredness is stronger than expected and appetite weaker. Splitting meals, keeping a visible water bottle and placing useful objects at hand height remove half of the risky trips across the flat.

A single sheet on the kitchen table — visit times, practice number, GP number, today's treatments — serves the patient and the relative who calls in at the end of the day. We leave one at every first visit.

Finally, a dedicated care surface saves time: clean, clear, at working height, where supplies stay between visits instead of being scattered across three rooms.

When to call

Redness spreading around a scar, a new discharge, unexplained fever, pain that increases instead of easing, a fall even without immediate pain, or an inability to take a prescribed treatment: report these the same day, to the practice or to the GP.

Outside our hours the rule is that of any emergency: 15, or 112 from a mobile.

What we write down at the first visit

The first visit produces a short but structuring record: condition observed on arrival, discrepancies with the discharge report, equipment present and missing, access to the home, who to contact, and the visit rhythm agreed.

That record goes to the GP the next day. It serves as a point zero: everything that changes later — healing, independence, tolerance of a treatment — is read against it rather than against a memory.

Frequently asked questions on this page

Terms explained

PRADO

The health insurance discharge support programme: an adviser arranges the first community appointments from the hospital before discharge.

Prescription

A doctor's written order stating the procedure, frequency and duration. Without it, nursing care cannot be delivered or reimbursed, apart from procedures allowed in direct access.

Home hospitalisation (HAD)

A structure delivering hospital-level care at the patient's home, with its own medical coordination.

Handover notes

The written record of a visit: what was done, what was observed, what must be watched. The shared memory of the care episode.

Anticoagulant

A medicine that slows blood clotting to prevent a clot. It requires watching for bleeding and, for some, regular blood tests.

INR

A blood test measuring clotting, used to adjust the dose of vitamin-K antagonist anticoagulants.