The transition from pediatric to adult care can be confusing for patients, parents and families. It means new doctors, new routines and possibly new treatment plans. Furthermore, the transfer of legal responsibility to the patient (upon reaching adult age) can be emotionally and logistically troubling for parents or caregivers. This doesn’t even take into account the numerous life changes these young adult patients are already facing outside their medical care.
Transitioning pediatric patients shouldn’t be taken lightly, as many unforeseeable challenges could deter patients from receiving the care and support they require and deserve. But sadly, more than 50 percent of parents polled by the National Survey of Children with Special Health Care Needs claimed no one even spoke to them about the upcoming need for their child to switch to adult care.
In some cases, patients may be dismissed because of age without any healthcare plan in place. In other cases, patients struggle to find an adult provider who is familiar or experienced with their specific healthcare needs.
Healthcare professionals—this is your call to action. Just because your patients are technically of adult age (or nearing it) doesn’t mean the fear and anxiety caused by their medical condition vanishes. Patients and families need better guidance as they near the age of transition. Here are some steps to help aid them in this shift.
Create a Transition Policy
This policy should include a time frame for when the pediatric patient will be expected to transition, a thorough explanation of how your practice will assist in the transition, and an outline of any legal changes that may take place related to privacy and consent at age 18. Once created, be sure to speak with the patient, parents and family about the transition policy, and assist with any questions they may have.
Track & Monitor Transitioning Youth
Providers should establish a system for identifying and tracking patients in their system as they near and enter into the transitional age bracket. This will ensure they don't slip between the cracks and receive timely information and assistance as needed.
Help Parents Prepare a Readiness Assessment
Underage patients close to transitioning into adult care should know the answers to several questions concerning their health condition and care. Early on (roughly age 14), healthcare professionals should devise an assessment (and involve parents and caregivers) to encourage the child to learn important information about themselves, including:
- Their medical condition(s) by name
- Their doctor’s name and how to contact them for questions or to schedule an appointment
- Who to contact in case of a medical emergency
- Their dietary or medical restrictions
- Their current medications
- If there are any potentially negative interactions with their medications
- How to fill their prescriptions
- What to do if they have a negative reaction to medication
- How to identify a fever by body temperature
- A general understanding of their insurance policy
- Their family’s medical history
Plan for the Transition
Planning for the actual transition will be a collaborative and continuous process. Establish the youth’s care priorities during and after transition. Create a medical summary and emergency plan to help support their growing independence, and connect patients and family members with community-based supports (should they need it).
It can be emotionally difficult for parents to pass the decision-making baton to their child. Treat this step of the transition process with sensitivity and compassion.
Finally, healthcare providers should discuss preferences regarding the selection of an adult provider. This should include giving the patient and family a list of recommended adult healthcare providers who are familiar with accepting patients just transitioning out of pediatric care.
Create a Transfer Package
This package should consist of:
- A transfer letter
- Transition goals
- A completed readiness assessment
- Actions accomplished or yet to be accomplished
- A medical summary and emergency care plan
- Any relevant legal documents
If the patient’s condition is particularly rare or complex, a condition fact sheet should also be included.
Contact the New Adult Provider
Especially when dealing with a particularly complex or rare condition, contact the new adult provider to onboard them and discuss any special needs of the patient. Some patients have specific ways in which they prefer to be treated, such as using certain patient comfort measures to improve their experience . These details should also be relayed to the new provider to help make the transition as smooth as possible.
If the transition is successful, it’s a good idea for healthcare professionals to continue an ongoing, collaborative relationship with the adult primary care provider for future referrals.
Follow Up With the Patient and Family
Reach out to the young adult and parent or caregiver three to six months after their last pediatric visit to ensure the transition to adult care went according to plan. This is an important step, as it will indicate whether the transition process your practice implemented is successful.
Successful transfer from pediatric to adult healthcare should be completed before the patient reaches 22 years of age. By following these steps, you can ensure your young patients receive the care they need as they grow into adulthood and transfer out of your practice.
Whether pediatric patients are 2 or 20, you will want to provide the best patient comfort available. Discover how you can continue to improve pediatric patient care in this free guide.