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Methods to Assess Transition Readiness & other Novel Tools and Resources Sen Ravindran, PGY4 Jill Sullivan, PGY4 Advances in CKD 2011.

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Presentation on theme: "Methods to Assess Transition Readiness & other Novel Tools and Resources Sen Ravindran, PGY4 Jill Sullivan, PGY4 Advances in CKD 2011."— Presentation transcript:

1 Methods to Assess Transition Readiness & other Novel Tools and Resources Sen Ravindran, PGY4 Jill Sullivan, PGY4 Advances in CKD 2011

2 Disclosures We have no commercial relationships to disclose. Partners in Youth and Disabilities

3 Objectives  Compare and contrast validated transition readiness tools (patient and parent)  Discuss Novel Health Care Provider and Parental resources and support tools  What’s happening in subspecialty transition? Partners in Youth and Disabilities

4 Validated transitional readiness tools 1.TRAQ (Transitional Readiness Assessment Questionaire 5.0) – JAX HATS (Jacksonville Health and Transition Services)

5 Validated transitional readiness tools 1.TRAQ (Transitional Readiness Assessment Questionaire 5.0) – JAX HATS (Jacksonville Health and Transition Services) 2.STARx and TRxANSITION – UNC-CH (Kidney Disease)

6 Validated transitional readiness tools 1.TRAQ (Transitional Readiness Assessment Questionaire 5.0) – JAX HATS (Jacksonville Health and Transition Services) 2.STARx and TRxANSITION – UNC-CH (Kidney Disease) 3.US Department of Health Resources and Service Administration / Maternal and Child Health Bureau (MCHB) created GotTransition.org Toolkit packages - Six Core Elements.

7 Validated transitional readiness tools 1.TRAQ (Transitional Readiness Assessment Questionaire 5.0) – JAX HATS (Jacksonville Health and Transition Services) 2.STARx and TRxANSITION – UNC-CH (Kidney Disease) 3.US Department of Health Resources and Service Administration / Maternal and Child Health Bureau (MCHB) created GotTransition.org Toolkit packages - Six Core Elements. 4.Transitional Skills Checklist (Univ of Wisconsin) – Long, comprehensive checklist (not discussed)  Who/What/Where (N. Shah) Stepwise transition with Quizzes  Graduation (Sickle Cell)

8 JaxHATS

9 TRAQ VIDEOS

10 TRAQ - JaxHATS “The Jacksonville Health and Transition Services (JaxHATS) clinic was created to help make this transition easier. JaxHATS serves teens and young adults, ages 16-26, with chronic medical or developmental problems” They endorse the TRAQ (Transitional Readiness Assessment Questionnaire), a 20 item questionnaire with 5 subcategories:  Managing Medications  Appointment Keeping  Tracking Health Issues  Talking with Providers  Managing Daily Activities Gregory S. Sawicki, et al. Measuring the Transition Readiness of Youth with Special Healthcare Needs: Validation of the TRAQ—Transition Readiness Assessment Questionnaire. J. Pediatr. Psychol. (2011) 36(2): 160-171

11 JaxHATS

12 Ready, Set, Stop: Mismatch Between Self-Care Beliefs, Transition Readiness Skills, Transition Planning Among Adolescents, Young Adults, and Parents – Sawicki et al 2014 -High confidence in self care but reported low scores for discrete readiness measures like knowing medications (ex). There is a disconnect. Transition readiness Skills Acquestion in adolescents and young adults with inflammatory bowel disease: findings from integrating assessment into clinical practice – Inflam Bowel Dis. 5/2015 -Most are not demonstrating transition readiness by TRAQ questionnaire, transition readiness associated with older age (P<0.001) and female (P<0.001)

13 UNC-CH - STARx  Developed by UNC Kidney Care/Pediatrics. Self-management and Transition from pediatric to Adult-focused health care with Rx=treatment (STARx) Program – 3 sections, 18 questions!  UNC-CH / Kidney Care started founded the STARx program in 2006, the main focus was to develop and improve self- management skills and disease knowledge among adolescents and young adults with chronic health conditions.  Spanish and English versions  Also a more comprehensive TRxANSITION questionnaire was developed (Sex/Reproduction addressed – big difference)

14 UNC-CH – STARx Section 1

15 UNC-CH – STARx Section 2

16 UNC-CH – STARx Section 3

17 UNC-CH - TRxANSITION  T – Type of Chronic Health Condition ( ex: Name of your illness?)  Rx – Medications (ex: What are the names of your meds? When do you take them?  A - Adherence (ex: Do you usually have trouble remembering your meds?)  N - Nutrition (ex: Are you supposed to follow any special diet?)  S - Self-management skills (ex: Do you make your own MD appointments?)  I - Issues of reproduction (ex: Would your condition affect your ability to become pregnant?)  T - Trade/School (ex: Future plans in regards to school/job?)  I - Insurance (ex: What’s the name of your health insurance provider?)  O - Ongoing support (ex: when you are an adult, who will help you?)  N - New health care providers (ex: When it comes for you to switch to an adult MD, how will you find one?)

18 UNC-CH - TRxANSITION  T – Type of Chronic Health Condition ( ex: Name of your illness?)  Rx – Medications (ex: What are the names of your meds? When do you take them?  A - Adherence (ex: Do you usually have trouble remembering your meds?)  N - Nutrition (ex: Are you supposed to follow any special diet?)  S - Self-management skills (ex: Do you make your own MD appointments?)  I - Issues of reproduction (ex: Would your condition affect your ability to become pregnant?)  T - Trade/School (ex: Future plans in regards to school/job?)  I - Insurance (ex: What’s the name of your health insurance provider?)  O - Ongoing support (ex: when you are an adult, who will help you?)  N - New health care providers (ex: When it comes for you to switch to an adult MD, how will you find one?)

19 UNC-CH - TRxANSITION  T – Type of Chronic Health Condition ( ex: Name of your illness?)  Rx – Medications (ex: What are the names of your meds? When do you take them?  A - Adherence (ex: Do you usually have trouble remembering your meds?)  N - Nutrition (ex: Are you supposed to follow any special diet?)  S - Self-management skills (ex: Do you make your own MD appointments?)  I - Issues of reproduction (ex: Would your condition affect your ability to become pregnant?)  T - Trade/School (ex: Future plans in regards to school/job?)  I - Insurance (ex: What’s the name of your health insurance provider?)  O - Ongoing support (ex: when you are an adult, who will help you?)  N - New health care providers (ex: When it comes for you to switch to an adult MD, how will you find one?)

20 UNC-CH - TRxANSITION  T – Type of Chronic Health Condition ( ex: Name of your illness?)  Rx – Medications (ex: What are the names of your meds? When do you take them?  A - Adherence (ex: Do you usually have trouble remembering your meds?)  N - Nutrition (ex: Are you supposed to follow any special diet?)  S - Self-management skills (ex: Do you make your own MD appointments?)  I - Issues of reproduction (ex: Would your condition affect your ability to become pregnant?)  T - Trade/School (ex: Future plans in regards to school/job?)  I - Insurance (ex: What’s the name of your health insurance provider?)  O - Ongoing support (ex: when you are an adult, who will help you?)  N - New health care providers (ex: When it comes for you to switch to an adult MD, how will you find one?)

21 UNC-CH - TRxANSITION  T – Type of Chronic Health Condition ( ex: Name of your illness?)  Rx – Medications (ex: What are the names of your meds? When do you take them?  A - Adherence (ex: Do you usually have trouble remembering your meds?)  N - Nutrition (ex: Are you supposed to follow any special diet?)  S - Self-management skills (ex: Do you make your own MD appointments?)  I - Issues of reproduction (ex: Would your condition affect your ability to become pregnant?)  T - Trade/School (ex: Future plans in regards to school/job?)  I - Insurance (ex: What’s the name of your health insurance provider?)  O - Ongoing support (ex: when you are an adult, who will help you?)  N - New health care providers (ex: When it comes for you to switch to an adult MD, how will you find one?) GOTTRANSITION.ORG Checklist

22 Compare/Contrast TRxANSITION 32?s T – Type of Health condition Rx – Meds A – Adherence N – Nutrition S – Self-management skills I – Issues of Reproduction T- Trade/school I – Insurance O – Ongoing support N – New Healthcare providers STARx 18?s Self-Management Transition from Pediatric to Adult Focused Healthcare with Rx (In the past 3 months) How Often? How Much? (Assess knowledge) How easy or hard ? (Comfort level) TRAQ 20?s Managing medication Appointment Keeping Tracking Health Issues Talking with Providers Managing Daily Activities

23 GotTransition.org – 6 core elements 1.Transition Policy (this conference’s goal) 2.Transition Tracking and Monitoring 3.Transition Readiness 4.Transitional Planning 5.Transfer of Care 6.Transfer Completion

24

25

26 3 toolkits for 3 scenarios: Transitioning Youth to Adult Health Care Providers (Peds, FM, Med-Peds) Transitioning to Adult Approach to Health Care Providers WITHOUT changing providers (FM and Med-Peds) Integrating Young Adults into Adult Health Care (Internal Med, FM, Med- Peds)

27 GotTransition.org – 6 core elements 1.Transition Policy (GHS subspecialists?) 2.Transition Tracking and Monitoring 3.Transition Readiness -Sample Transitional Readiness Assessment for Youth* -Sample Transitional Readiness Assessment for Parents/Caregivers* 1.Transitional Planning 2.Transfer of Care 3.Transfer Completion

28

29 MY HEALTH  “I know my medications, what they are for, when I need to take them” USING HEALTHCARE How the patient “navigates” healthcare  “ I know my current plan of care”  “ I know where my current pharmacy is and how to fill my meds”

30 TRANSITION IMPORTANCE AND CONFIDENCE

31 GotTransition.org – 6 core elements 1.Transition Policy (GHS subspecialists?) 2.Transition Tracking and Monitoring 3.Transition Readiness 4.Transitional Planning - Sample Plan of Care - Sample Medical Summary & Emergency Care Plan - Sample Condition Fact Sheet 1.Transfer of Care 2.Transfer Completion

32 GotTransition.org – 6 core elements 1.Transition Policy (GHS subspecialists?) 2.Transition Tracking and Monitoring 3.Transition Readiness 4.Transitional Planning - Sample Plan of Care - Sample Medical Summary & Emergency Care Plan - Sample Condition Fact Sheet 1.Transfer of Care 2.Transfer Completion

33 GotTransition.org – 6 core elements 1.Transition Policy (GHS subspecialists?) 2.Transition Tracking and Monitoring 3.Transition Readiness 4.Transitional Planning - Sample Plan of Care - Sample Medical Summary & Emergency Care Plan - Sample Condition Fact Sheet 1.Transfer of Care 2.Transfer Completion This will serve as a Medical Passport – main Diagnoses, PMH/PSH, Meds/All, Key contacts, etc.

34 GotTransition.org – 6 core elements 1.Transition Policy (GHS subspecialists?) 2.Transition Tracking and Monitoring 3.Transition Readiness 4.Transitional Planning 5.Transfer of Care - Sample Transfer of Care Checklist - Sample Transfer Letter* 6.Transfer Completion - Sample Transition Feedback Survey for Youth and Parents/Caregiver

35 GotTransition.org – 6 core elements 1.Transition Policy (GHS subspecialists?) 2.Transition Tracking and Monitoring 3.Transition Readiness 4.Transitional Planning 5.Transfer of Care - Sample Transfer of Care Checklist - Sample Transfer Letter 6.Transfer Completion - Sample Transition Feedback Survey for Youth and Parents/Caregiver

36  The Readiness Scores don’t tell us about the “Perfect Storm,” health literacy, incorrect self-reporting, socioeconomic barriers, concurrent mental illness, fears  The HEADS AT is an adaptation of HEADSS psychosocial review for adolescents.

37 The HEADS AT is an adaptation of HEADSS psychosocial review for adolescents. ADOLESCENT H ome & Environment E ducation (Bullying) & Employment A ctivities D rugs/Drinking S exuality S uicide/Depression

38 The HEADS AT is an adaptation of HEADSS psychosocial review for adolescents. ADOLESCENT H ome & Environment E ducation (Bullying) & Employment A ctivities D rugs/Drinking S exuality S uicide/Depression TRANSITION H ome & Environment – ADLs, services, equipment, mobility E ducation (Bullying) & Employment – IEP, OT, PT, ST, Adaptive communication, job/vocation training A ctivities – Peers, Interest, Socialization D evelopment/Drugs/Depression – Coping? Depression, Agitation, Abuse, EtOH, Tob, Illicits Specialist – Cards, GI, etc, last/next visit and main diagnoses (I would add sexuality here) A ncillary – therapies, agencies T ransition/Goals - Future vision, Guardianship /Will, Knows meds, Knows about illness

39 Novel resources and tools(1) Online Resources (in addition to Got Transition.org)  Autism Speaks/ Autism Intervention Research Network on Physical Health  Parental Tool  Rare Toolkits – Global Genes Project  SickKids.com  Healthcare Transition Research Consortium (HTRC) – new research Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Camp Spike and Dome), Camp Courage (Greenville, SC)

40 Novel support tools & projects Online Resources (in addition to GotTransition.org): Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Healthcare Transition Research Consortium (HTRC) Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Academics: Residency curriculum - HEADS-AT and QI

41 Novel support tools & projects Online Resources (in addition to GotTransition.org): Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Healthcare Transition Research Consortium (HTRC) Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Academics: Residency curriculum - HEADS-AT and QI

42 Novel support tools & projects Online Resources (in addition to GotTransition.org): Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Healthcare Transition Research Consortium (HTRC) Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Academics: Residency curriculum - HEADS-AT and QI

43 Novel resources and tools(1) Online Resources (in addition to Got Transition.org)  Autism Speaks/ Autism Intervention Research Network on Physical Health  Rare Toolkits – Global Genes Project  SickKids.com (QI – Transitional Website?)  Healthcare Transition Research Consortium (HTRC) – new research Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Camp Spike and Dome), Camp Courage (Greenville, SC)

44 Novel support tools & projects Online Resources: - Autism Speaks/ Autism Intervention Research Network on Physical Health - Rare Toolkits – Global Genes Project - SickKids.com Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship “RARE Toolkits provide individuals with usable information on a variety of topics related to living with and/or advocating for rare diseases” - Pediatric Palliative Care, Mitochondrial disorders, etc

45 Novel resources and tools(1) Online Resources (in addition to Got Transition.org)  Autism Speaks/ Autism Intervention Research Network on Physical Health  Rare Toolkits – Global Genes Project  SickKids.com (Transitional Website QI?)  Healthcare Transition Research Consortium (HTRC) – new research Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Camp Spike and Dome), Camp Courage (Greenville, SC)

46 Novel support tools & projects Online Resources (in addition to Got Transition.org) Autism Speaks/ Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Healthcare Transition Research Consortium Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Academics: Residency curriculum - HEADS-AT and QI

47 Novel resources and tools(1) Online Resources (in addition to Got Transition.org)  Autism Speaks/ Autism Intervention Research Network on Physical Health  Rare Toolkits – Global Genes Project  SickKids.com (QI – Transitional Website?)  Healthcare Transition Research Consortium (HTRC) – new research Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Camp Spike and Dome), Camp Courage (Greenville, SC)

48 Novel support tools & projects Online Resources: Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Healthcare Transition Consortium and Got Transition.org Academics: Residency curriculum - HEADS-AT and QI

49 Novel resources and tools(1) Online Resources (in addition to Got Transition.org)  Autism Speaks/ Autism Intervention Research Network on Physical Health  Rare Toolkits – Global Genes Project  SickKids.com (QI – Transitional Website?)  Healthcare Transition Research Consortium (HTRC) – new research Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Camp Spike and Dome), Camp Courage (Greenville, SC)

50 Novel support tools & projects Online Resources: Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Healthcare Transition Consortium and Got Transition.org Academics: Residency curriculum - HEADS-AT and QI

51 Online Resources: Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Healthcare Transition Consortium and Got Transition.org Academics: Residency curriculum - HEADS-AT and QI

52 Novel resources and tools (2) Mentoring Programs: Partners in Youth with Disability Transition Clinic: ATLAS – Adolescents Transitioning to Leadership and Success – Duke Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Medical Passports (SickKids.com) / Flashdrives Academics: Residency curriculum – QI, applying HEADS-AT, bolstering transitional curriculum

53 Novel support tools & projects Online Resources: Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Healthcare Transition Consortium and Got Transition.org Academics: Residency curriculum - HEADS-AT and QI

54 Novel support tools & projects Online Resources: Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Healthcare Transition Consortium and Got Transition.org Academics: Residency curriculum - HEADS-AT and QI

55 Novel resources and tools (2) Mentoring Programs: Partners in Youth with Disability Transition Clinic: ATLAS – Adolescents Transitioning to Leadership and Success – Duke Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Medical Passports (SickKids.com) / Flashdrives Academics: Residency curriculum – QI, applying HEADS-AT, bolstering transitional curriculum (what we’re working on now!)

56 Healthcare passports (SickKids) Online Resources: Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Healthcare Transition Consortium and Got Transition.org Academics: Residency curriculum - HEADS-AT and QI

57 Healthcare passports (UNC) Online Resources: Autism Intervention Research Network on Physical Health Rare Toolkits – Global Genes Project SickKids.com Camps: Epilepsy Foundation of Texas transition program during a weeklong summer camp (Summer 2014); and Victory Junction (UNC) Mentoring Programs – Partners in Youth with Disability Transition Coordinators/Navigator Model in DM1 HEADS-AT Training Tool for Residents Transition Clinics / Good 2 Go Transition Program (Good 2 Go) Medical Passport (UNC and SickKids) Advance Care Planning / Guardianship Adolescents Transitioning to Leadership and Success (ATLAS). Based on the CHIPS program. Healthcare Transition Consortium and Got Transition.org Academics: Residency curriculum - HEADS-AT and QI

58 Outcomes from Subspecialities  Improved Patient-Reported Outcomes (QOL, Functional status, perceived Health Status) and Positive Patient experience. Chaudhry, SR. Evaluation of a Cystic fibrosis transition program from pediatric to adult care. Pediatr Pulmonology 2013. Univ of Michagan. Survey of 91, 44 went through the CF program, reported improved symptoms/QOL  Reduced Medical Complications and Greater Adherence to Care. Cadario et al. Transition process of patients with T1 Diabetes from paediatric to the adult health care service: A hospital-based approach. Clinical Endocrinology – 2009. *Survey of 62 pts; 30 underwent a formal transition program and had lower A1c at adult follow-up  New Disease specific questionnaires. Zijlstra et al. Self efficacy in adolescents with IBD: A pilot study of the “IBD yourself,” a disease- specific questionnaire. 2013 Journal of Crohn’s and Colitis. *Correlates with Transition readiness.

59 Take Home Points  There are multiple transitional readiness assessments tools: TRAQ, STARx, TRxANSITION, GotTransition.org toolkits  Explore their home/social context using HEADS-AT as this may reveal transition barriers  There are multiple numerous novel resources: Autism Speaks, SickKids, RareToolkit, HCTC, Camps, Mentoring programs. Apps/Tech and Medicolegal issues discussed this afternoon  Resident QI opportunities abound!

60 Take Home Points  There are multiple transitional readiness assessments tools: TRAQ, STARx, TRxANSITION, GotTransition.org toolkits  Explore their home/social context using HEADS-AT as this may reveal transition barriers  There are multiple numerous novel resources: Autism Speaks, SickKids, RareToolkit, HCTC, Camps, Mentoring programs. Apps/Tech and Medicolegal issues this afternoon  Resident QI opportunities abound! This entire conference stemmed from one AAP 7/2014 QI project!

61

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