Abstract
Purpose
To describe the process of developing, and evaluating the feasibility and acceptability
of, an EMR-based transition readiness assessment.
Design and methods
A Cerner-based version of the UNC TRxANSITION Index was implemented across four pediatric subspecialty clinics: epilepsy,
inflammatory bowel disease; type 1 diabetes, oncology survivorship. The feasibility
was assessed by each's clinic's ability to meet form completion goals and their assessment
rate. Acceptability was assessed via family refusal rate, a staff-completed feedback
questionnaire, and whether the form was adopted into routine clinical care after completion
of the pilot study.
Results
All clinics met form completion goals (N = 10/clinic). The assessment rate ranged from 66 to 100% across clinics. No families
refused completion of the form. Most staff (70%) reported completing the form in <10
min. Staff reported on challenges experienced and provided recommendations to streamline
administration and enhance clinical care. All staff reported the form helped them
identify knowledge gaps in their patients. Two clinics continued using the form following
completion of the pilot study.
Conclusions
Implementation was most feasible in clinics that were well-staffed and had lengthier
patient visits, however, time and staff resources were the biggest challenges to implementation
across clinics. Based on staff feedback to improve efficiency and developmentally-tailor
assessment, the form will be divided into Beginner Skills and Advanced Skills.
Practical implications
Integrating transition readiness assessment into the EMR has the potential to improve
clinical care by facilitating staff's ability to efficiently identify knowledge gaps
in their transition-aged patients and intervene.
Keywords
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Article info
Publication history
Published online: December 16, 2022
Accepted:
November 29,
2022
Received in revised form:
November 29,
2022
Received:
July 12,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
