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Current practices for the transition and transfer of patients with a wide spectrum of pediatric-onset chronic diseases: Results of a clinician survey at a free-standing pediatric hospital (pp. 507-515) $0.00
Authors:  Susan M. Fernandes, Laurie Fishman, Joanne O’Sullivan-Oliveira, Sonja Ziniel, Patrice Melvin, Paul Khairy, Rebecca O’Brien, Romi A. Webster, Michael J. Landzberg, and Gregory S. Sawicki
Abstract:
Health care transition is a process in which adolescents with chronic disease develop disease self-management skills allowing for successful transfer to adult-centered health systems.
Objective: To determine current clinician practices and perceived barriers to transition of care at a large academic free-standing children’s hospital. Methods: A web-based, multiple choice, cross-sectional survey was randomly distributed to 479 outpatient clinicians.
Results: Overall, the response rate was 77% (368/479), with 329 (89%) providing outpatient care to patients >11 years of age. Most respondents stated that transitioning skills assessment/education was provided to their patients (72%), usually informally (92%) between the ages of 11-16 years (48%). Clinicians felt that transfer to an adult oriented health care system should be based on age (79%), adult co-morbidities (79%) and graduation from college (67%). The parents’ emotional attachment to the institution and the parents’ /patients’ emotional attachment to the provider were felt to be the most common barrier to transfer (96% and 95% respectively). Most respondents agreed that the institution should provide resources for the development of transitioning programs (90%) and to streamline the transfer process (95%).
Conclusion: The majority of clinicians at our free-standing pediatric hospital report providing transitioning skills assessment/education, but most state that they do so informally without a structured program. Providers identify parents’ and patients’ emotional attachment to both the provider and institution as a major barrier. Clinicians desire departmental and institutional resources for transitioning skills education and assessment, as well as streamlining the transfer of patients to an adult oriented healthcare system. 


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Current practices for the transition and transfer of patients with a wide spectrum of pediatric-onset chronic diseases: Results of a clinician survey at a free-standing pediatric hospital (pp. 507-515)