Topics For Discussion at Transition Planning Meetings Should at a Minimum Include:
■ Client history;
■ Assessments, including functional status;
■ Diagnosis, investigations and results;
■ Medication and allergies;
■ Safety information;
■ Equipment requirements or recommendations;
■ Care needs;
■ Advanced directives;
■ Information and education for the client, their family and caregivers;
■ Consultations and discharge summaries; and
■ Follow-up requirements.
Foundational
Care Transitions
Point of Care Resources