Transitioning an adolescent dialysis patient to adult health care.

B.H. eventually met the outcome goals and made the transition into an adult facility. Throughout the process, the dialysis staff discussed ideas and plans for the future with B.H. and encouraged increased self-determination, however, the time frame was not adequate to allow each step of the process to be carried out. No concerted effort was made on the part of the entire multidisciplinary team to enable the patient to make a successful transition. A step-driven protocol sensitive to the patient's developmental, cognitive, and social situation must be implemented into the standards of care. In this way, independence can be fostered at an early stage and continued as the patient matures.