Hospital to Home · Cairns & FNQ

The first days home are the riskiest.
We cover them.

CareLink takes a hospital discharge plan and turns it into safe clinical care at home, with senior nursing from the first morning and structured reporting back to the hospital team and GP.

The gap we close

Discharged is not the same as recovered.

Patients leave hospital with a wound plan, a medication chart, follow-up appointments and a family doing its best. What’s often missing is the clinical layer at home: someone qualified to do the dressings, run the IV course, watch for deterioration and tell the GP what’s actually happening. That layer is CareLink.

  • Post-surgical wound care continued at home
  • IV antibiotic courses completed without readmission to a ward
  • New catheters and devices managed by trained nurses
  • Complex medication changes supported clinically
  • Frail and medically complex patients monitored closely
  • Palliative discharges supported alongside the care team
How the handover works

From ward round to front door.

1
Referral and discharge summary

The discharge planner, treating team or GP sends the referral with the discharge summary attached.

2
Senior nurse review

We review the plan before discharge wherever possible, and flag anything that needs clarifying while the team is still reachable.

3
First visit at home

Scheduled around the discharge, with a full clinical assessment in the home setting.

4
Reporting loop

Progress notes back to the GP and, where wanted, the hospital team. Deterioration is escalated immediately, not at the next appointment.

For discharge planners

A discharge you can defend.

When the barrier to a safe discharge is clinical care at home, CareLink is the answer you can write into the plan. One referral, a named senior nurse, and updates that reach you and the GP without chasing.

  • Referrals accepted by form, fax or phone
  • Prompt clinical review of every referral
  • Pre-discharge liaison with the treating team where possible
  • Closure summary when the episode of care ends

Make the discharge plan hold at home.

Refer before discharge where you can. The earlier we see the plan, the smoother the first morning home.

Request clinical support