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River Hills Community Health Center Pediatrician Focus Group

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Rachel Christine
Rachel Christine

This document discusses supporting the transition from pediatric to adult healthcare. It defines healthcare transition as a planned process moving from child-centered pediatric care to patient-centered adult care. The goal is to maximize lifelong well-being for youth, including those with special needs. However, only about 50% of parents discuss changing needs with pediatricians and 42% discuss switching providers. A comprehensive transition leads to better outcomes. Early education helps youth feel comfortable taking on new responsibilities. Successful transitions can prevent readmissions. The document proposes a quality improvement initiative to develop transition toolkits for use across community health centers to support this process.

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Supporting the Transition from Pediatric to Adult Health Care
Definition of Health Care Transition: The purposeful, planned and timely transition from child and family-centered pediatric health care to patient-centered adult-oriented health care. (Society for Adolescent Medicine, 1993) 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. Only about 50 percent of parents report discussing their adolescents changing health care needs with a pediatrician, and of those only 42 percent had discussed switching to an adult provider. (Pediatrics, 2009) Identified as a need by IPCA and RH staff
A comprehensive and coordinated transition to adult care makes for better outcomes for children and young adults Early education about transitioning helps youth feel more comfortable with taking on new responsibilities and more empowered when it comes to their own health Successful transitions can help prevent readmissions to the hospital in young adulthood (18-24) Transitioning to another RH provider helps with continuity of care and keeps children in one system
River Hills Community Health Center Pediatrician Focus Group
Part 1: Quality Improvement Initiative Patient Centered Medical Home Designation 5C: Coordinate With Facilities and Care Transitions Collaborates with the patient/family to develop a written care plan for patients transitioning from pediatric care to adult care Pilot at River Hills Community Health Center (Pediatric Clinic) Part 2: Develop Transitioning Toolkit to be used by providers at all community health centers across Iowa
River Hills Community Health Center Pediatrician Focus Group
Transition of Care Checkbox *On Initial Intake form, Care Management Plan form, and Pediatric CC/HPI form **Currently shows up at age 16 working to change it so checkbox appears at age 12
River Hills Community Health Center Pediatrician Focus Group
Adolescent Transition of Care Form Added to two office visit types: PEDS Chronic PEDS Well-Child (+1 year) Physicals 14 Yes/No Questions broken down into three age ranges 3 Domains Increasing Adolescent Responsibility for Healthcare Management Readiness Assessment for Transfer to Adult Care Implementation of Transfer to Adult Care Gradually complete questions as child moves through adolescence
Adolescent Transition of Care Form
Patient Medical Record
HCT Index Provider Survey
Other Transition Toolkits http://newenglandconsortium.org/for- families/transition-toolkit/ http://rwjms.rutgers.edu/boggscenter/product s/BeingaHealthyAdultHowtoAdvocateforYourHe althandHealthCare.html http://healthytransitionsny.org/skills_media/to ol_show
Discussion What are you already doing in your clinical practice to support this transition period? How do you think it could be improved? How do you think parents will respond to these questions being asked? How do you think adolescents will respond to these questions? What educational materials might you need to supplement these discussion?
THANK YOU!
References Lotstein, Debra S., et al. "Planning for health care transitions: results from the 20052006 national survey of children with special health care needs." Pediatrics 123.1 (2009): e145-e152. Cooley, W. Carl, and Paul J. Sagerman. "Supporting the health care transition from adolescence to adulthood in the medical home." Pediatrics 128.1 (2011): 182-200.

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River Hills Community Health Center Pediatrician Focus Group

  • 1. Supporting the Transition from Pediatric to Adult Health Care
  • 2. Definition of Health Care Transition: The purposeful, planned and timely transition from child and family-centered pediatric health care to patient-centered adult-oriented health care. (Society for Adolescent Medicine, 1993) 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. Only about 50 percent of parents report discussing their adolescents changing health care needs with a pediatrician, and of those only 42 percent had discussed switching to an adult provider. (Pediatrics, 2009) Identified as a need by IPCA and RH staff
  • 3. A comprehensive and coordinated transition to adult care makes for better outcomes for children and young adults Early education about transitioning helps youth feel more comfortable with taking on new responsibilities and more empowered when it comes to their own health Successful transitions can help prevent readmissions to the hospital in young adulthood (18-24) Transitioning to another RH provider helps with continuity of care and keeps children in one system
  • 5. Part 1: Quality Improvement Initiative Patient Centered Medical Home Designation 5C: Coordinate With Facilities and Care Transitions Collaborates with the patient/family to develop a written care plan for patients transitioning from pediatric care to adult care Pilot at River Hills Community Health Center (Pediatric Clinic) Part 2: Develop Transitioning Toolkit to be used by providers at all community health centers across Iowa
  • 7. Transition of Care Checkbox *On Initial Intake form, Care Management Plan form, and Pediatric CC/HPI form **Currently shows up at age 16 working to change it so checkbox appears at age 12
  • 9. Adolescent Transition of Care Form Added to two office visit types: PEDS Chronic PEDS Well-Child (+1 year) Physicals 14 Yes/No Questions broken down into three age ranges 3 Domains Increasing Adolescent Responsibility for Healthcare Management Readiness Assessment for Transfer to Adult Care Implementation of Transfer to Adult Care Gradually complete questions as child moves through adolescence
  • 12. HCT Index Provider Survey
  • 13. Other Transition Toolkits http://newenglandconsortium.org/for- families/transition-toolkit/ http://rwjms.rutgers.edu/boggscenter/product s/BeingaHealthyAdultHowtoAdvocateforYourHe althandHealthCare.html http://healthytransitionsny.org/skills_media/to ol_show
  • 14. Discussion What are you already doing in your clinical practice to support this transition period? How do you think it could be improved? How do you think parents will respond to these questions being asked? How do you think adolescents will respond to these questions? What educational materials might you need to supplement these discussion?
  • 16. References Lotstein, Debra S., et al. "Planning for health care transitions: results from the 20052006 national survey of children with special health care needs." Pediatrics 123.1 (2009): e145-e152. Cooley, W. Carl, and Paul J. Sagerman. "Supporting the health care transition from adolescence to adulthood in the medical home." Pediatrics 128.1 (2011): 182-200.