What a wound care discharge handoff has to do

A wound care discharge handoff should let someone who has never met the patient pick up the plan on the first day home, without calling the facility to ask what the orders meant.

Wound plans tend to fail in the first week home for ordinary reasons: no supplies, unclear orders, nobody sure who is doing the dressing and no follow-up on the calendar. This checklist complements our discharge planner wound referral checklist, which covers making the referral itself.

The wound summary

Write one section per wound, numbered the way the facility chart numbers them.

  • Location, with side, and wound type as documented by the treating clinician
  • When and how it started, and the stage if it is a pressure injury
  • The most recent measurements and the date they were taken
  • Appearance at the last assessment: tissue, drainage, odor and surrounding skin
  • The trend over the stay
  • Procedures during the stay, such as debridement, with dates
  • Culture results and any antibiotic, with its planned stop date
  • Circulation testing, imaging and labs that bear on healing

If the resident was seen on facility wound rounds, include the treating clinician’s most recent note.

Orders someone at home can follow

Facility treatment orders are written for nurses with a stocked cart. Before they go home, check that they still make sense.

  1. Each wound has its own order: the cleanser, the dressing described by type, any secondary dressing and how it is secured.
  2. The frequency is stated, along with what to do if the dressing loosens or leaks between changes.
  3. Compression, offloading, positioning and weight-bearing instructions are written out.
  4. The order names who will do the changes: home health, a caregiver, the patient or a combination.
  5. A clinician has signed the orders, and a named clinician will handle changes after discharge.

That last point causes more trouble than any other. Settle it before discharge.

Supplies and equipment for the first days

Assume the first delivery will be late.

  • Send enough dressing supplies to cover the gap until the home health agency or supplier delivers.
  • List supplies by type and size so they can be reordered.
  • Confirm that pressure-relieving equipment, such as a mattress overlay or wheelchair cushion, will be in the home on arrival.
  • Send offloading footwear and compression garments home with the patient.
  • For negative pressure wound therapy, arrange the home device and supplies before discharge day.

Gateway can help with wound supplies and DME coordination when a partner clinician is following the patient. Who pays for an item depends on the patient’s coverage.

The person doing the dressing changes

Find out who will be hands-on at home, and meet them before discharge day. A daughter who first hears about the wound in the parking lot is not prepared.

Have the caregiver watch a dressing change and then do one with a nurse present. Give written steps in plain language. If the caregiver cannot manage it, say so in the handoff so the agency can plan visits around the dressing schedule.

Tell the patient and caregiver which changes to report: spreading redness, more drainage, new odor, fever, increasing pain or a dressing that will not stay in place. Tell them who to call, and that an emergency means 911. Our hospital discharge checklist for families can go in the packet.

Follow-up with names and dates

“Follow up with your doctor” is not a plan. The handoff should list:

  • The home health agency, its phone number and the expected first visit
  • The wound follow-up visit, with the clinician’s name and office number
  • The primary care visit after discharge
  • Specialist appointments, such as vascular, podiatry or surgery
  • Transportation arrangements for any outpatient visit

If the patient cannot get to a clinic, ask about wound follow-up at home. Gateway arranges wound follow-up after discharge with partner clinicians in Greater St. Louis and the Metro East. Availability is confirmed by address, and the treating clinician decides the plan of care.

Sending the handoff

Send the packet to every receiver, not only the patient: the home health agency, the primary care office and the wound clinician. For complicated wounds, follow it with a call to the agency’s intake nurse. A short conversation catches what paper does not.

To involve Gateway, call 314-325-0126, fax referral documents to 314-786-7966 or request a referral callback. The online form takes contact details only, so keep clinical information out of it. Our page for hospitals and discharge planners describes the process.

Common questions

How many days of wound supplies should go home with the patient?

Enough to cover the gap until the next supplier is delivering, with a small margin. Ask the home health agency or supplier when the first delivery is expected, and count dressing changes from discharge to that date. Your facility’s policy and the patient’s coverage affect what can be sent.

Who writes wound orders after the patient leaves the facility?

Usually not the facility physician. Once the patient is home, orders come from the clinician who takes over, which may be the primary care clinician, a surgeon or a wound clinician. Home health agencies need a named, reachable clinician to sign and update orders.

Should wound photos be included in the handoff?

If your organization’s policy and the patient’s consent allow it, a recent dated photo helps the receiving clinician more than a description alone. Send photos only through approved, secure channels, never by personal text message. Otherwise, a precise written description with measurements and a date does the job.

What if the patient is going home without home health?

Then caregiver teaching and the follow-up visit carry more weight. Confirm who will change the dressing, that they have shown they can do it, where supplies will come from and when a clinician will next see the wound. If those answers are shaky, raise it with the physician before discharge.

Related pages

Updated October 2026