TY - JOUR
AU - E. A. Minchau
AU - B. S. Vance
AU - E. Barnes
A1 - 
AB - BACKGROUND: Emerging adults with type 1 diabetes (T1D) struggle with glycemic management that can be exacerbated by a disorganized transition process. Substantial gaps in care have been noted during this transition period and have been shown to lead to suboptimal health care utilization, worsening glycemic management, increased incidence of serious complications, and mental health challenges. A formal transition program can help prevent gaps in care, improve disease self-management skills, decrease disease burden, and reduce diabetes complications. PURPOSE: There is an increased focus within the pediatric community to formally prepare young adults with T1D as they transition to the adult health care setting. The purpose of the quality improvement initiative was to develop a transition program for adolescents with T1D in a pediatric endocrinology clinic within an academic medical center. METHODS/INTERVENTIONS: The Institute for Healthcare Improvement Model for Improvement was used to guide this project. Got Transition's® Six Core Elements of Health Care Transition were adapted to the unique needs of the pediatric endocrinology setting by incorporating diabetes-specific transition guidelines recommended by the American Diabetes Association (ADA). A new program was designed to target patients between the ages of 16-18 offering structured transition visits focused on enhancing knowledge and skills related to the management of T1D and improving the transfer of care process between pediatric and adult providers. Key elements of the program were integrated into the electronic health record. A focus group with clinical partners was used to evaluate the acceptability and practicality of the program. RESULTS: Transition activity within the clinic increased from 12/32-28/32 on the Current Assessment of Healthcare Transition Activities tool. Four themes were identified from clinical partner feedback supporting the acceptability and practicality of program design. CONCLUSIONS: The integration of the Got Transition® framework and the ADA recommendations supports clinicians in meeting the unique needs of adolescents with T1D. Incorporating the transition activities into the electronic health record facilitated integration into the workflow of the clinic providers. This initiative can serve as a model to expand transition activities across pediatric specialty care settings.
AD - Department of Adult Health, School of Nursing, West Virginia University (Dr. Minchau), Morgantown, WV, USA.; Department of Family and Community Health, School of Nursing, West Virginia University (Dr. Vance), Morgantown, WV, USA.; School of Nursing, West Virginia University (Dr. Barnes), Morgantown, WV, USA.
AN - 39712597
BT - Health Care Transit
C5 - Healthcare Disparities
DO - 10.1016/j.hctj.2024.100073
DP - NLM
ET - 20241014
JF - Health Care Transit
LA - eng
N2 - BACKGROUND: Emerging adults with type 1 diabetes (T1D) struggle with glycemic management that can be exacerbated by a disorganized transition process. Substantial gaps in care have been noted during this transition period and have been shown to lead to suboptimal health care utilization, worsening glycemic management, increased incidence of serious complications, and mental health challenges. A formal transition program can help prevent gaps in care, improve disease self-management skills, decrease disease burden, and reduce diabetes complications. PURPOSE: There is an increased focus within the pediatric community to formally prepare young adults with T1D as they transition to the adult health care setting. The purpose of the quality improvement initiative was to develop a transition program for adolescents with T1D in a pediatric endocrinology clinic within an academic medical center. METHODS/INTERVENTIONS: The Institute for Healthcare Improvement Model for Improvement was used to guide this project. Got Transition's® Six Core Elements of Health Care Transition were adapted to the unique needs of the pediatric endocrinology setting by incorporating diabetes-specific transition guidelines recommended by the American Diabetes Association (ADA). A new program was designed to target patients between the ages of 16-18 offering structured transition visits focused on enhancing knowledge and skills related to the management of T1D and improving the transfer of care process between pediatric and adult providers. Key elements of the program were integrated into the electronic health record. A focus group with clinical partners was used to evaluate the acceptability and practicality of the program. RESULTS: Transition activity within the clinic increased from 12/32-28/32 on the Current Assessment of Healthcare Transition Activities tool. Four themes were identified from clinical partner feedback supporting the acceptability and practicality of program design. CONCLUSIONS: The integration of the Got Transition® framework and the ADA recommendations supports clinicians in meeting the unique needs of adolescents with T1D. Incorporating the transition activities into the electronic health record facilitated integration into the workflow of the clinic providers. This initiative can serve as a model to expand transition activities across pediatric specialty care settings.
PY - 2024
SN - 2949-9232
SP - 100073
ST - Development of a transition program for emerging adults with type 1 diabetes: A quality improvement initiative
T1 - Development of a transition program for emerging adults with type 1 diabetes: A quality improvement initiative
T2 - Health Care Transit
TI - Development of a transition program for emerging adults with type 1 diabetes: A quality improvement initiative
U1 - Healthcare Disparities
U3 - 10.1016/j.hctj.2024.100073
VL - 2
VO - 2949-9232
Y1 - 2024
ER -