Challenges to Transitioning Patients from Pediatric to Adult Healthcare
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
Discuss the challenges of transitioning patients from pediatric to adult healthcare settings.
Keyword(s): Hospitals, Children With Special Needs
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.