The transition from child to adult is one filled with many changes. And one of the most important changes is transitioning from a pediatric to adult health care practitioner.
Proper planning and ongoing discussions with both parents and children beginning in early adolescence can make the transition occur more smoothly. This process can be accomplished through provider, family, and adolescent readiness planning.
Developing a plan for your practice to support children in their transition to adult care providers is essential to ensure patients receive quality, uninterrupted, and age-appropriate care.
It is recommended that care providers create an office policy for their transition process that is readily available to practitioners, parents/guardians, and adolescents. According to gottransition.org , this policy and process should be a part of planning for all adolescents, including those with special needs.
The policy should outline how this process is going to be documented, such as with a form in a paper chart or through prompts in an electronic health record (EHR), and at what age it should begin.
Family members need to be educated about their role in the transition process, including the legal changes that occur once a child reaches age 18 and how pediatric and adult care are delivered differently. Providers should be prepared to address any family stress and questions regarding this transition.
The adolescent must be viewed as the driver behind this process, according to gottransition.org . Discussions should begin in early adolescence, ideally around 12 years of age, with the goal to complete the process between the ages of 18 and 21. To assess the patient's readiness for transition, physicians can download and administer the Boston Children’s Hospital's ADAPT Survey .
Topics that should be discussed during this process include plans after graduation, such as attending college, joining the military, or entering the workforce, as these can impact the care transition process for young adults.
In its report, the American Academy of Pediatrics (AAP) recommends including four key components in a transition plan:
Review the 2011 American Academy of Pediatrics (AAP) report titled "Supporting the Health Care Transition from Adolescence to Adulthood in the Medical Home" for practical guidance to help plan and execute this transition for children and their families, along with additional guidance on establishing transition plans for adolescent patients.