Online Program

Challenges to Transitioning Patients from Pediatric to Adult Healthcare

Monday, November 2, 2015 : 3:30 p.m. - 3:50 p.m.

Caren Steinway, MSW, MPH, PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA
Symme Trachtenberg, MSW, LSW, The Children's Hospital of Philadelphia, Philadelphia, PA
Adam Greenberg, CRNP, The Children's Hospital of Philadelphia, Philadelphia, PA
Sophia Jan, MD, MHSP, The Children's Hospital of Philadelphia, PA
Background: Transition from pediatric to adult healthcare is challenging for youth with special healthcare needs. Little research has been done to document the heterogeneity of provider perspectives on transition within a pediatric healthcare system.

Methods: An online survey designed to benchmark transition policies, processes, and obstacles, was developed and sent via email to division chiefs, all social work staff, members of a voluntary hospital-wide Transition Special Interest Group, and all advanced practice nursing staff in a large, free-standing, urban, tertiary-care, teaching children’s hospital. Division chiefs were asked to forward the survey to additional appropriate faculty and staff.

Results: There were 153 responses (22%) representing 28 divisions (93%). The most common trigger for transition was age (87.5%). Obstacles to transition ranked most important included: agreement and consensus among multiple providers on when or how to transfer care (54.2%), provider agreement whether or not to transition patients (39.9%), and provider agreement on appropriate age or time to start discussing transition (33.3%). Most respondents reported not following recommended guidelines to: send medical records to adult providers (62%), send medical summary to adult providers (57%), send plans of care to adult providers (78%), and have a formal transition policy (87%). 

Conclusions: There was little consensus among pediatric providers about the transition process despite presence of national guidelines. Few divisions followed national guidelines, including transfer of medical records and development of a medical summary prior to transfer to an adult provider.

Learning Areas:

Administration, management, leadership
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
Discuss the challenges of transitioning patients from pediatric to adult healthcare settings.

Keyword(s): Hospitals, Children With Special Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a current graduate student in social work and public health. Through my graduate school experience I have conducted research on transition for the past 3 years. In addition, I have worked with patients going through the transition process and led psychoeducational programs for transition aged youth.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.