Transitioning Pediatric Patients to Adult Care: A Readiness Needs Assessment

Transitioning Pediatric Patients to Adult Care: A Readiness Needs Assessment


Name: Nichole Benson

Rank: LCDR

Presenter/Poster: Podium

Year: 2017


Medically complex adolescents and young adults (ages 16-21) are at increased risk for healthcare disengagement, increased hospitalizations, poor treatment adherence, and poor health outcomes when their transitional healthcare needs from pediatric care to adult care are not met. To ensure optimal health outcomes, American Academy of Pediatrics, American Academy of Family Physicians, and American College of Physicians recommend deliberately designing key care processes that focus on preparing adolescents to be ready for transition to adult care. Our military treatment facility (MTF) has recently formed a process improvement working group to ensure that medically complex adolescents and young adults receiving their care at the outpatient and pediatric specialty care clinics are adequately prepared for their transition to adult health care. Part of this process improvement includes performing a needs assessment that details the current readiness to transition to adult care for the medically complex adolescents that receive their healthcare at our MTF’s adolescent and specialty care clinics. Therefore, the purpose of this evidence based project was to conduct a needs assessment using the validated adolescent and parent/caregiver STARx transition readiness questionnaires.
The STARx transition readiness questionnaires were administered to all patients between the ages of 16-21 and their parent/caregiver presenting to the outpatient adolescent and pediatric specialty care clinics - between September 19th and December 16th, 2016. Two-hundred and fifty-nine adolescents (137 females, 113 males, and 2 transgender) and 262 parent/caregivers completed the STARx transition readiness questionnaires from multiple clinics including general pediatrics (n=74), adolescent (n=48), gastrointestinal (n=40), endocrinology (n=26), neurodevelopmental (n=23), neurology (n=15), nephrology (n=11), hematology/oncology (n=7), cardiac (n=5), pulmonary (n=5), and nutrition (n=5). Adolescent participants endorsed 100 different diagnoses with the most reported diagnoses related to mental health, endocrinological, and gastrointestinal issues. One-hundred six of the adolescents scored 70 points or greater on the STARx transition questionnaire, suggesting that they are ready to transition to adult care. Group comparisons (e.g., based on diagnoses categories and gender) and adolescent vs adult/caregivers are being analyzed for any differences in their readiness to transition scores on the STARx questionnaire. Results and implications for targeting transitioning care process improvement changes will be discussed.