The CareTransition program is designed to make your transition from hospital to home a smooth one, aiming to reduce the risk of an unplanned readmission. The program provides you with a tailored plan to complement and enhance the discharge process, to support you to optimise your recovery at home.

What is CareTransition?

CareTransition is a program that has been designed to make your transition from hospital to home a smooth one. Your CareTransition Coach will support you to build skills to manage your health after your hospital stay, including and may assist with identifying early warning signs of potential issues post-discharge and strategies for what you could do if they occur. They can also help you to prepare for appointments with doctors or other health professionals.

How does CareTransition help?

When you’ve been in hospital, the transition home can be a confusing time. CareTransition may help take the guesswork by providing you with the support you may require to feel more confident to manage your conditions/health issues at home.

Your care coordinator will liaise with your doctor to help identify your needs. We may also support you with managing your medication, preparing for the first visit post discharge with your doctor, or even talking to your other care providers. In short, we aim to ensure that you receive the support you may need during this vulnerable time.

How does CareTransition work?

CareTransition is typically a 30-day program that begins when you are discharged from hospital. Generally, it starts with our care coordinator visiting you at home to work with you to set your personal health goals, discussing your care needs to help you through this transition period.

You will receive ongoing phone calls to check on how things are going, and you will be able to ask all the questions you may have. Support also includes an information pack that may assist you to track your health, medications and any follow-up medical appointments.

Frequently Asked Questions

Where is the program available?

The program is available in most metropolitan areas of Australia*.

How do I know if I’m eligible for the program?

You may be eligible for CareTransiton if you:

  • are over the age 60
  • have had at least one hospitalisation in the last 12 months
  • have a health condition such as: Chronic Heart Failure, Cardio-vascular Disease, Chronic Obstructive Pulmonary Disease, Asthma or Diabetes
  • have been admitted with the following clinical conditions: Clinical Cardiology, Endocrinology, Respiratory Medicine, Vascular Surgery.

You may also be eligible if you have a planned hospital admission or have had an unplanned hospital admission and have been discharged within the last 10 days. To find out more about CareTransition or your eligibility please contact us.

Why is this program being offered?

Amplar Health wants to better support customers going home after a hospital admission. We know discharging from hospital can feel overwhelming. We also know that if people stay well, it may reduce the pressure on the health system overall.

Amplar Health believes that programs such as CareTransition can help empower individuals to know what they can do to help manage their health.

I’m already getting support services from another provider when I get home. Why would I need this program as well?

CareTransition does not replace other health care services. It offers you with support to help you managing your health condition/issue, such as clarifying questions about medication or preparing you for follow-up appointments. Your care coordinator will be focused on the goals that are most important to you in your transition to home.

How can this program help me?

On leaving hospital, you may be given a lot of information and instructions on what to do once you get home. This can be overwhelming. Your care coordinator aims to support you to make a smooth transition from hospital to home, which may alleviate stress and reduce the risk of you having an unplanned readmission to hospital.

What’s involved if I participate?

Your care coordinator will go through your discharge information with you including your medications and, if you have any changes to your medications, that you know what to do.

If you’ve been given other discharge instructions, your care coordinator will go through them with you and help you develop a plan to help you follow these instructions. They can also answer any questions you may have, and help you work out how to get back to your normal routine and activities.

What’s a care coordinator?

A care coordinator is an allied health professional such as a physiotherapist or occupational therapist. All CareTransition care coordinators hold current registration to practice with the Australian Health Practitioners Regulation Agency (AHPRA) or their relevant professional organisation. A care coordinator focuses on coordinating your care and assists you in identifying and achieving your health goals.

What’s a customer care consultant?

A customer care consultant provides administrative support for the CareComplete programs. Customer care consultant will also interact virtually with participants to check in on their progress and provide information when required.

I’ve already got good support in place. Why would I need this program?

CareTransition aims help take the guesswork by providing you with the support you may require helping you feel more confident to manage your health issue/condition at home. Your care coordinator will provide you with tools and support so that you may feel more confident with self-management of your health or conditions.

Does this program cost me anything?

For eligible participants, the program itself is cost-free.

However, if there are costs involved in any of the services recommended during the program, and if you choose to go with these services such as a dietitian appointment, physiotherapy appointment or other services, our care coordinator will discuss with you the options and associated costs beforehand. We will not enrol you into any program for any additional services if you do not agree to them.

Depending on your level and types of cover, your private health insurance provider may cover some of these costs. We recommend you contact your health fund to ask if they will over the costs of those services and how much, before you elect to go with those services.

How is my privacy protected?

We are committed to protecting your privacy as part of your participation in the CareTransition program. We will handle your personal information in accordance with all applicable Commonwealth and State legislation, which governs use collection, disclosure, storage, access and disposal of personal information.

For detailed information about how we handle your personal information, you can read our privacy policy here.

*Not available in all areas. Availability depends on the particular program, location and provider availability.

Need other support at home?

Through our CareComplete programs, Amplar Health supports people through care coordination and one-on-one health coaching.