Feasibility and use of a transition process planning and communication tool among multiple subspecialties within a pediatric health system

Abstract

Purpose: An emerging need to improve health care transition planning has developed worldwide as more youth with special health care needs are surviving to adulthood. Nurses have been instrumental in facilitating transition planning and supporting youth throughout this process. While various transition tools have been developed, health professionals' utilization and perception of these tools have yet to be explored. Furthermore, there are no universally-accepted documentation tools for transition planning. The purpose of this study was to develop and implement a transition process planning and communication tool to facilitate transition planning among multiple, pediatric subspecialties within a system-wide transition program.Design and Methods: This project was a cross-sectional quality improvement initiative. Eligible encounters in the electronic medical record (N = 20,645) were obtained from 38 subspecialty clinics at a large, freestanding pediatric health system.Transition planning documentation was monitored for 8 months pre-implementation and 14 months post-implementation of the tool. Health professionals (N = 89) completed a survey to assess the tool's feasibility.Results: Implementation of the tool was feasible and corresponded with increased transition planning documentation post-implementation. Nurses represented 33% of the sample that utilized the tool. Survey results revealed barriers to documentation and utilization of the tool, along with strategies for improvement.