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.
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.
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Got Transition: Center for Health Care Transition Improvement
Got Transition aims to advance access to effective transition support from pediatric to adult health care for all youth, including those with special needs. Aligned with the Clinical Report, Got Transition supports practices in the implementation and evaluation of transition quality improvement through the Six Core Elements of Health Care Transition.
Comprehensive tool packages are available for three transition processes:
1) transitioning youth to adult health care providers,
2) transitioning youth to an adult approach to health care without changing providers
3) integrating youth into adult health care.
These packages include sample policies, registries, transition readiness/self-care assessments, condition fact sheets, medical summary and emergency care plans, transfer letters and checklists, young adult orientation material, care plans and feedback surveys. Additionally, Got Transition has developed two different measurement approaches (one subjective, one objective) to assess the extent to which the Six Core Elements of Health Care Transition are being incorporated into clinical processes. Download the Six Core Element packages at GotTransition.org. These tools may be adapted and customized for an individual practice.
For more information about Got Transition contact firstname.lastname@example.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.
Advancing Healthcare Transitions in the Medical Home: Tools for Providers, Families and Adolescents with Special Healthcare Needs
This August 2013 publication in Current Opinion Pediatrics reviews national guidelines regarding healthcare transition planning for adolescents with special healthcare needs and describes practical tools for use by the primary care pediatrician to implement these guidelines.
Youth with Special Health Care Needs: Transition to Adult Health Care Services
This Maternal and Child Health Journal (November 2012) article highlights a study to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.
This May 2013 article from the National Initiative for Children's Healthcare Quality shares examples of how pediatric medical homes are helping young adults make smooth transitions to adult care.
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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