Highlights
- •.It’s possible to integrate a HCT workflow starting early, with evidence informed national guidelines tailored to site needs.
- •Surveys of stakeholders on barriers fostered participant engagement and increased adoption of workflow.
- •Using a variety of prompts and incorporating all team members in the QI process.
- •increased uptake of transition workflow.
Abstract
Background
Despite well-known guidelines to prepare adolescents to transition to adult care,
research has shown that this is done less than 25% of time in pediatric practice.
This quality improvement (QI) project aimed to improve the transition readiness process
for all adolescents aged 14–18 at health care maintenance visits.
Methods
A multidisciplinary team conducted a quality improvement initiative in a large, urban
pediatric academic teaching practice serving a low-income, multi-ethnic population.
The team developed transition interventions through successive Plan-Do-Study-Act cycles.
They included a formal transition readiness assessment tool, provider-delivered education
related to transition readiness, and delivery of a transition brochure for all adolescents.
The team used run charts to follow the rate of formal transitions discussions documented
in the electronic medical record.
Results
Over the course of 36 months the outcome measure of provider documented transition
readiness discussions increased from 19 to 64% of the time. Over the same course of
time, the process measures of transition brochure distribution and completion of the
readiness assessment tool increased from 0 to 94% and 0 to 84% respectively.
Conclusions
QI methodology and multidisciplinary coordinating to streamline workflow, distribution
of transition information, readiness assessment and provider discussion and documentation
can be successfully incorporated into a busy primary care setting. By formalizing
and standardizing the transition readiness process, pediatric providers can improve
young adults' readiness to transition to adult medical care.
Keywords
Abbreviations:
HCT (Health Care Transition), PCC (Primary Care Clinician), LCSW (Licenced Clinical Social Worker), PSR (Patient Service Representative), PDSA (Plan Do Study Act)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 04, 2022
Accepted:
June 11,
2022
Received in revised form:
June 10,
2022
Received:
December 21,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
