Supporting Safe Transitions from Hospital to Home

Transformative Nursing & Support Services provides nurse-led community care for individuals transitioning from hospital to home across Townsville and North Queensland. Our experienced clinical team works collaboratively with hospitals, discharge planners, allied health professionals, and support coordinators to ensure continuity of care and safe recovery in the community.

We understand that many patients leaving hospital require additional support to manage complex health needs at home. Our services are designed to provide short-term and ongoing assistance that promotes recovery, reduces hospital readmission, and supports independence in a familiar environment.

Our team can provide a range of clinical and personal supports following hospital discharge, including:

• Post-surgical recovery support
• Wound care and dressing management
• Medication management and monitoring
• Catheter and continence care
• Support for complex disability transitions
• Short-term intensive support following discharge
• Ongoing community nursing supports

We regularly work with individuals who require additional support after leaving hospital, including:

• NDIS participants requiring increased supports
• Older people transitioning to in-home aged care services
• Individuals recovering from surgery or illness
• People with complex or chronic health conditions
• Patients requiring short-term clinical monitoring at home

Our team values strong communication and collaboration with health professionals. We aim to provide clear updates and work closely with discharge teams, general practitioners, allied health providers, and support coordinators to ensure each person receives the right level of care.

Referrals from hospitals and health professionals are welcomed.

1. Submit a referral via our online referral form or contact our team
2. Our intake team reviews the referral and confirms service availability
3. An intake assessment is arranged to develop a tailored support plan
4. Services commence in collaboration with the patient and care team

New referrals are typically acknowledged within 24 hours.

We provide services across:

Townsville
Magnetic Island
Burdekin
Charters Towers
North Queensland

If you would like to discuss a referral or confirm service availability, please contact our intake team and we will be happy to assist.