Transitions
A new clinical report—Supporting the Health Care Transition from Adolescence to Adulthood in the Medical Home—appears in the July issue of Pediatrics. The report is jointly authored by the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Physicians (ACP) and the provides practical, detailed guidance on how to plan and execute better health care transitions for all patients.
Abstract
Optimal health care is achieved when each person, at every age, receives medically and developmentally appropriate care. The goal of a planned health care transition is to maximize lifelong functioning and well-being for all youth, including those who have special health care needs and those who do not. This process includes ensuring that high-quality, developmentally appropriate health care services are available in an uninterrupted manner as the person moves from adolescence to adulthood. A well-timed transition from child- to adult-oriented health care is specific to each person and ideally occurs between the ages of 18 and 21 years. Coordination of patient, family, and provider responsibilities enables youth to optimize their ability to assume adult roles and activities. This clinical report represents expert opinion and consensus on the practice-based implementation of transition for all youth beginning in early adolescence. It provides a structure for training and continuing education to further understanding of the nature of adolescent transition and how best to support it. Primary care physicians, nurse practitioners, and physician assistants, as well as medical subspecialists, are encouraged to adopt these materials and make this process specific to their settings and populations.
To link to the full clinical report, please click here.
For a direct link to the algorithm that is included in the clinical report,, please click here.
For questions about the clinical report contact transitions@aap.org.
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Got Transition: New National Health Care Transition Center
Got Transition is the new National Health Care Transition Center supporting optimal transitions for youth from pediatric to adult models of care and their seamless transfer to adult health care settings. Got Transition will facilitate the implementation and dissemination of health care transition best practices in primary care medical homes and specialty settings, particularly for those youth and young adults with special health care needs. Got Transition is leading health care transition learning collaboratives with pediatric and adult practices in Washington DC, Denver, and Boston. Teams of physicians care coordinators, and consumer youth and family members are implementing the Got Transition Six Core Elements of Health Care Transition a health care transition toolkit informed by the July 2011 AAP/AAFP/ACP clinical report. Teams are testing practice changes for their effectiveness and practicality to identify feasible improvement strategies.
- Six Core Elements of Health Care Transition
Apackage of tools and guidance, as well as the Health Care Transition Index, both pediatric 
and adult versions, for health care settings that are interested in improving and measuring their health care transition process. The tools and indices are designed to support an improved transition for youth and young adult patients in both pediatric and adult health care settings.
- When Young Adults Need Help with Decisions—Guardianship and Other Approaches to Decision-making Support
This brief describes a number of decision-making supports that may assist young adults with intellectual disabilities while assuring the highest degree of independence and self-direction. It also provides links to important resources regarding guardianship and other alternatives.
For more information about Got Transition contact ann.walls@gottransition.org, visit the Got Transition Web site, or follow Got Transition on Facebook.
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Medical Home Interview Videos 
Developed by the National Center for Medical Home Implementation
Improving Transition for Adolescents with Special Health Care Needs From Pediatric to Adult-Centered Care
AAP. Pediatrics. 2002;110:1301-1335
AAP Periodic Survey of Fellows #71—Adolescent Health Care
The survey explored pediatricians' practices regarding screening, management and referral for adolescent health care services, as well as pediatricians' participation in interdisciplinary
adolescent health care services and pediatricians' training needs in adolescent health.
A Primary Care Quality Improvement Approach to Health Care Transition
This article, published in the May issue of Pediatric Annals, looks at quality improvement methodology that can be used by pediatric, family medicine, and adult medical practices to optimize the transition for youth/young adults and their families as they move from pediatric health care to adult health care systems.
Health Care Transitions for Youth with Special Health Care Needs: An Analysis of National and State Performance 
(January 2011)
National Alliance to Advance Adolescent Health
Nationally, less than half of all youth with special health care needs, ages 12 through 17, successfully transition from pediatric to adult health care. This report provides new national and state information to establish a transition baseline, examine state variation in transition performance, and explore possible reasons for this variation. Information for this report was obtained from the 2005-2006 National Survey of Children with Special Health Care Needs and the 2010 Current Population Survey.
Pediatric Perspectives on Transitioning Adolescents with Special Health Needs to Adult Health Care (October 2008)
National Alliance to Advance Adolescent Health
This fact sheet presents new national data on the transition support services offered in pediatric practices to adolescents with special needs and the barriers affecting their availability.
Spotlight on Child Health Issues: Transitioning From a Pediatric to an Adult Medical Home
National Center for Medical Home Implementation
This issue highlighted how challenging transitioning from pediatric to adult-oriented care can be, especially for youth with special health care needs. The issue also included promising practices that support families, youth, young adults, and providers as well as information regarding systems changes in states that provide technical assistance, training, and resources to pediatric and adult providers. The issue concluded with a list of resources for providers (including the clinical report), youth, and families.
The Center for Children with Special Needs—Transition Resources
The spring 2012 issue of The Center for Children with Special Needs e-Newsletter features a variety of resources for adolescents, parents, and providers to prepare for the transfer from pediatric to adult care. Resources highlighted in the issue include:
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