Improving the Transition of Adolescents from Disadvantaged Backgrounds from Pediatric to Adult Primary Care Providers.
Adolescent medicine
Continuity of care
Healthcare access
Primary care
Transitions of care
Journal
Journal of pediatric nursing
ISSN: 1532-8449
Titre abrégé: J Pediatr Nurs
Pays: United States
ID NLM: 8607529
Informations de publication
Date de publication:
Historique:
received:
01
03
2021
revised:
23
07
2021
accepted:
23
07
2021
pubmed:
4
8
2021
medline:
15
12
2021
entrez:
3
8
2021
Statut:
ppublish
Résumé
The lack of structured transition interventions for adolescents aging out of pediatric care is associated with poor health outcomes. We assessed the effectiveness of a transition protocol that aimed to improve the transfer of adolescents to adult primary care. Chart reviews were conducted on 21- and 22-year-old patients seen 18 months before and after protocol implementation. Completion of an adult medicine appointment scheduled within 6 months from the last pediatric visit was the primary outcome of interest. In pre-implementation period, 20.9% of patients versus 39.3% in post-implementation period were transferred. Transfer was higher in patients who had a dedicated transition visit, had a transition order placed, and were tracked during the transfer process. A transition protocol can increase the number of adolescents who transfer to adult care. Once a patient is ready to transition, a dedicated transition visit is ideal; however, providers should incorporate transition care during any clinical encounter. While an electronic transition order can facilitate appointment scheduling, patient tracking and appointment reminders can help ensure appointment completion. In addition, all clinical staff should receive transition training and clinicians should be frequently reminded about the need to transition their patients. However, even with these efforts to support transition, the majority of patients did not do so, which indicates a continued need to develop and evaluate transition interventions. Implementing a transition protocol in pediatric clinics can improve the transition of adolescents aging out of pediatric care and may diminish gaps in medical care that can be associated with poor health outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
The lack of structured transition interventions for adolescents aging out of pediatric care is associated with poor health outcomes.
METHODS
METHODS
We assessed the effectiveness of a transition protocol that aimed to improve the transfer of adolescents to adult primary care. Chart reviews were conducted on 21- and 22-year-old patients seen 18 months before and after protocol implementation. Completion of an adult medicine appointment scheduled within 6 months from the last pediatric visit was the primary outcome of interest.
FINDINGS
RESULTS
In pre-implementation period, 20.9% of patients versus 39.3% in post-implementation period were transferred. Transfer was higher in patients who had a dedicated transition visit, had a transition order placed, and were tracked during the transfer process.
DISCUSSION
CONCLUSIONS
A transition protocol can increase the number of adolescents who transfer to adult care. Once a patient is ready to transition, a dedicated transition visit is ideal; however, providers should incorporate transition care during any clinical encounter. While an electronic transition order can facilitate appointment scheduling, patient tracking and appointment reminders can help ensure appointment completion. In addition, all clinical staff should receive transition training and clinicians should be frequently reminded about the need to transition their patients. However, even with these efforts to support transition, the majority of patients did not do so, which indicates a continued need to develop and evaluate transition interventions.
PRACTICE IMPLICATIONS
CONCLUSIONS
Implementing a transition protocol in pediatric clinics can improve the transition of adolescents aging out of pediatric care and may diminish gaps in medical care that can be associated with poor health outcomes.
Identifiants
pubmed: 34343766
pii: S0882-5963(21)00227-X
doi: 10.1016/j.pedn.2021.07.023
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
269-274Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare that there is no conflict of interest.