Original articlePediatric to Adult Transition: A Quality Improvement Model for Primary Care
Section snippets
Methods
This study involved five large academic primary care practices in the District of Columbia (Washington, DC) that participated in a transition LC between 2011 and 2012. Two were adolescent clinics (with 11,000 visits/year and 1,830 visits/year); one was a pediatric clinic (with 15,000 visits/year); one was a family medicine resident clinic (with 10,000 visits/year); and one was an internal medicine clinic (with 35,000 visits/year). Each practice formed a team consisting of a lead physician, a
Office policy on transition
At the outset of the project, all participating sites were at the basic level (AS = 1.2) with respect to an office policy on transition. None of the pediatric practices had a written transition policy, and adult practices had no privacy or consent policy beyond the Health Insurance Portability and Accountability Act (HIPAA) policy routinely given to patients. Between Times 1 and 2, practices made substantial changes (AS = 4.8). Written policies were developed and tested by each transition team,
Discussion
Substantial improvements were made in transition clinical processes in both pediatric and adult practices using the Six Core Elements of Health Care Transition. All pediatric and adult sites established formal practice-wide policies on transition and more clearly informed youth, parents, and young adults about privacy and consent as a basic tenet of adult-centered care. All sites created a systematic method for tracking transitioning youth with chronic conditions, and the vast majority
Acknowledgments
M.M. conceptualized and interpreted the quality improvement results, drafted the background and results for the initial article, and approved the final article submitted. P.W., W.C.C., and J.W.M. made substantial contributions to the design and measurement of the quality improvement model, acquisition and interpretation of results, drafting the article, and gave approval of the final article as submitted. A.B., B.D., K.H., N.Q., and L.T. made significant contributions to the analysis and
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2022, Journal of Pediatric NursingCitation Excerpt :Changes the team thought would make big differences did not always occur when tested, such as targeted posters for staff to distribute brochures and tools and posters reminding patients to ask about HCT. As found in other HCT QI projects, support and involvement by the clerical, nursing, and medical administrators was essential for success of the project (McManus et al., 2015). Reviews of the HCT literature have been critical of manuscripts about HCT interventions for not providing enough pragmatic detail for others to incorporate the interventions into practice.
Conflicts of Interest: The authors have indicated that they have no financial relationships relevant to this article or conflicts of interest to disclose.