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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 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
Milestones Growing number of children with complex health conditions Transfer from pediatric to adult facility is another milestone
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
definitions Blum et al., 1993; Sawyer et al., 1997
Transition literature • Literature • Solid organ transplant • Human immunodeficiency virus • Cystic fibrosis • Diabetes • Other chronic illness populations • National practice and research priority
Transition: coordinator Perspective • 35 pediatric and 24 adult liver transplant coordinators • Results highlight important role of communication and partnership between pediatric and adult programs
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
Transition resources American Society of Transplantation
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
Transition resources The Hospital for Sick Children, Toronto http://www.sickkids.ca/Good2Go/
Transition resources“Good 2 go” http://www.sickkids.ca/Good2Go/
Transition resources“Good 2 go” http://www.sickkids.ca/Good2Go/
Transition resources“Good 2 go” http://www.sickkids.ca/Good2Go/
Transition resources“Good 2 go” http://www.sickkids.ca/Good2Go/
Transition resources: readiness checklist Sawicki, 2011
Transition resources: readiness survey Fredericks et al., 2010
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