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New Guidance Aims to Help Transition Youths From Pediatric to Adult Care
Report Is Collaborative Effort of AAFP, AAP, ACP
"Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home" provides detailed guidance on how to plan and execute optimal health care transitions for young patients. A collaborative effort of the AAFP, the American Academy of Pediatrics and the American College of Physicians, the report follows an algorithm -- which can be enhanced for youth with chronic conditions -- from age 12 through the transfer of care to an adult medical home.
"The goal of this document is to get everybody on the same page so family physicians know what to expect when they are asked to provide a medical home to a transitioning young adult," said Pickler, an assistant professor of family medicine, pediatrics and otolaryngology at the University of Colorado School of Medicine, Aurora. "A pediatrician also will know what to expect, and then we can start having relationships with them that are more collaborative and helpful from the patient perspective."
The report, which was published in the July issue of Pediatrics, specifically covers the respective roles of primary care physicians and subspecialists and outlines how to prevent omissions and redundancies in care.
- The AAFP, the American Academy of Pediatrics and the American College of Physicians have developed guidance on how to plan and execute health care transitions for adolescents and young adult patients.
- The organizations' joint report lays out goals for young patients transitioning from pediatric to adult care.
- This document informs pediatricians of what information the receiving physician needs and identifies steps family physicians should take to ensure a smooth transition.
- clearly identify the party responsible for medical decision-making;
- thoroughly explain adult consent and confidentiality policies to the patient and his or her family and other caregivers;
- communicate how the practice handles issues such as paperwork and medication refills; and
- discuss with the patient and his or her family and other caregivers how the practice may be accessed for routine and after-hours care.
Of particular importance, says the report, is effectively and efficiently transitioning young adults with special health care needs. When such patients transition from their pediatric to their adult medical home, the receiving physician has a responsibility to help them transfer from their pediatric subspecialists to adult subspecialty care.
According to Pickler, there have been extreme cases of young adults with special needs, such as transplant patients, who have died during care transitions because they ran out of medication.
"Kids have died because no one picked up the ball," she said. "That's why this is important. There are big things that can go wrong during this time, and senders and receivers need to be on the same page."
Family physicians don't always play the role of receiver, however, and Pickler said the report also can help guide family docs whose young adult patients are leaving their practice as they go off to college, start new jobs or have changes in insurance.
"The transition period is a formidable time for a young adult in that they have to do some things for themselves that they've never had to do before," she said. "It's kind of nice if a family physician can have the same nice, well thought out handoff (for a transitioning young patient) as he or she does for a patient going to or from a hospital or to or from a nursing home."
National Health Care Transition Center