McManus Margaret, White Patience, Barbour April, Downing Billie, Hawkins Kirsten, Quion Nathalie, Tuchman Lisa, Cooley W Carl, McAllister Jeanne W
The National Alliance to Advance Adolescent Health, Washington, DC.
The National Alliance to Advance Adolescent Health, Washington, DC.
J Adolesc Health. 2015 Jan;56(1):73-8. doi: 10.1016/j.jadohealth.2014.08.006. Epub 2014 Oct 3.
To examine the relationship between quality improvement activities with pediatric and adult primary care practices and improvements in transition from pediatric to adult care.
This was a time-series comparative study of changes in pediatric and adult practices involving five large pediatric and adult academic health centers in the District of Columbia. Using the Health Care Transition Index (pediatric and adult versions), we examined improvements in specific indicators of transition performance, including development of an office transition policy, provider knowledge and skills related to transition, identification of transitioning youth, transition preparation of youth, transition planning, and transfer of care.
Improvements took place in all six transition quality indicators in the pediatric and adult practices that participated in a 2-year learning collaborative to implement the "Six Core Elements of Health Care Transition," a quality improvement intervention modeled after the American Academy of Pediatrics/American Academy of Family Physicians/American College of Physicians Clinical Report on Transition. All sites established a practice-wide policy on transition and created an organized clinical process for tracking transition preparation. The pediatric sites conducted transition readiness assessments with 88% of eligible youth and prepared transition plans for 29% of this group. The adult sites conducted transition readiness assessments with 73% of eligible young adults and developed plans for 33%. A total of 50 were transferred in a systematic way to adult primary care practices.
Quality improvement using the Six Core Elements of Health Care Transition resulted in the development of a systematic clinical transition process in pediatric and adult academic primary care practices.
研究儿科和成人初级保健实践中的质量改进活动与从儿科护理向成人护理过渡的改善之间的关系。
这是一项对哥伦比亚特区五家大型儿科和成人学术健康中心的儿科和成人实践变化进行的时间序列比较研究。使用医疗保健过渡指数（儿科版和成人版），我们检查了过渡绩效的特定指标的改善情况，包括制定办公室过渡政策、与过渡相关的提供者知识和技能、识别过渡中的青少年、青少年的过渡准备、过渡计划以及护理转移。
参与了为期两年的学习合作以实施“医疗保健过渡的六个核心要素”的儿科和成人实践中的所有六个过渡质量指标都有所改善，该质量改进干预措施是仿照美国儿科学会/美国家庭医师学会/美国医师学院关于过渡的临床报告制定的。所有机构都制定了全机构范围的过渡政策，并创建了一个有组织的临床流程来跟踪过渡准备情况。儿科机构对88%符合条件的青少年进行了过渡准备评估，并为该群体中的29%制定了过渡计划。成人机构对73%符合条件的年轻人进行了过渡准备评估，并为33%的人制定了计划。共有50人被系统地转至成人初级保健实践机构。
使用医疗保健过渡的六个核心要素进行质量改进，在儿科和成人学术初级保健实践中形成了一个系统的临床过渡流程。
