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Moving on up: Pediatric to adult Transition

Moving on up: Pediatric to adult Transition. Stacee Lerret PhD, RN, CPNP, CCTC Medical College of Wisconsin Children ’ s Hospital of Wisconsin WI ITNS Annual Conference October 13, 2012. Financial Disclosure. None to report. Objectives. Milestones.

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Moving on up: Pediatric to adult Transition

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  1. Moving on up: Pediatric to adult Transition Stacee Lerret PhD, RN, CPNP, CCTC Medical College of Wisconsin Children’s Hospital of Wisconsin WI ITNS Annual Conference October 13, 2012

  2. Financial Disclosure None to report

  3. Objectives

  4. Milestones Growing number of children with complex health conditions Transfer from pediatric to adult facility is another milestone

  5. introduction • Definition • “Purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centered to adult-oriented health care systems”. • Blum et al., 1993

  6. definitions Blum et al., 1993; Sawyer et al., 1997

  7. Transition literature • Literature • Solid organ transplant • Human immunodeficiency virus • Cystic fibrosis • Diabetes • Other chronic illness populations • National practice and research priority

  8. Transition literature: consensus statements

  9. Transition Literature:Consensus statements

  10. Transition: coordinator Perspective • 35 pediatric and 24 adult liver transplant coordinators • Results highlight important role of communication and partnership between pediatric and adult programs

  11. Transition literature cont. • Despite literature and momentum to improve transition process limitations exist • Overall lack of consistency in healthcare and support services provided to young adults and their families • Insufficiencies may be related to adverse outcomes • Acute rejection • Graft loss

  12. Obstacles to successful transition

  13. Overcoming transition obstacles

  14. Overcoming transition obstacles

  15. Now What?

  16. Transition clinics

  17. Transition resources American Society of Transplantation

  18. Resources: Got transition • National Health Care Transition Center • http://www.gottransition.org/ • Got Transition • Partnership • National Alliance to Advance Adolescent Health • American Academy of Pediatrics • Target • Health care professionals • Families • Youth • Health policy makers • Content • Transition tools and tips

  19. Resources: got transition cont.

  20. Transition resources The Hospital for Sick Children, Toronto http://www.sickkids.ca/Good2Go/

  21. Transition resources“Good 2 go” http://www.sickkids.ca/Good2Go/

  22. Transition resources“Good 2 go” http://www.sickkids.ca/Good2Go/

  23. Transition resources“Good 2 go” http://www.sickkids.ca/Good2Go/

  24. Transition resources“Good 2 go” http://www.sickkids.ca/Good2Go/

  25. Transition resources: readiness checklist Sawicki, 2011

  26. Transition resources: readiness survey Fredericks et al., 2010

  27. conclusion • Important transplant and chronic illness issue • Goal to maximize health and quality of life • Live as independent and self sufficient adults • Literature regarding transition • Currently have single center experiences published in literature • More rigorous research • Limitations remain • Guide or framework • Checklists built into electronic medical record • National efforts • Consensus group • Transition workgroups

  28. Discussion and Questions

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