Esser Kayla, Adams Sherri, Chung Christopher, McKay Taylor, Moore Clara, Wagman Hayley, Lee Stephanie, Orkin Julia
Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Paediatr Child Health. 2024 Jun 19;29(5):274-279. doi: 10.1093/pch/pxae027. eCollection 2024 Aug.
Children with medical complexity have medical fragility, chronic disease, technology dependence, and high healthcare use. Their transition to adult health care at age 18 involves medical and social elements and follows no standardized process. Our goal was to improve transition readiness in children with medical complexity using a transition intervention within a Complex Care program. All children with medical complexity aged 14 to 18 were included in this quality improvement (QI) project (n = 54). We conducted a pre- and post-intervention chart review to assess transition outcomes and implemented a transition intervention for 6 months, which included an age-stratified checklist, charting template, and transition rounds. Before the intervention, 72% of 17- to 18-year-old patients had documented transition discussions, which increased to 86%. Patients with a family physician increased as well (61% to 73% for 17- to 18-year-olds). Three transition education rounds were held. The intervention increased transition readiness, provided tools to facilitate transition, and created a forum for conversation.
患有复杂疾病的儿童存在医疗脆弱性、慢性病、技术依赖且医疗保健使用率高。他们在18岁向成人医疗保健过渡涉及医疗和社会因素，且没有标准化流程。我们的目标是通过在复杂护理项目中实施过渡干预，提高患有复杂疾病儿童的过渡准备情况。所有14至18岁患有复杂疾病的儿童都纳入了这个质量改进（QI）项目（n = 54）。我们进行了干预前和干预后的病历审查以评估过渡结果，并实施了为期6个月的过渡干预，其中包括按年龄分层的检查表、病历模板和过渡轮次。干预前，17至18岁患者中有72%有记录在案的过渡讨论，这一比例增至86%。有家庭医生的患者也有所增加（17至18岁患者从61%增至73%）。举办了三轮过渡教育。该干预提高了过渡准备情况，提供了便于过渡的工具，并创建了一个对话论坛。
