An Intervention to Promote Healthcare Transition Planning Among Pediatric Residents

Albert C Hergenroeder; Heather Needham; Demonica Jones; Constance M Wiemann

doi:10.1016/j.jadohealth.2022.01.226

An Intervention to Promote Healthcare Transition Planning Among Pediatric Residents

J Adolesc Health. 2022 Jul;71(1):105-111. doi: 10.1016/j.jadohealth.2022.01.226. Epub 2022 Mar 26.

Authors

Albert C Hergenroeder¹, Heather Needham², Demonica Jones³, Constance M Wiemann³

Affiliations

¹ Baylor College of Medicine, Division of Adolescent Medicine and Sports Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas. Electronic address: alberth@bcm.edu.
² Kleck School of Medicine of the University of Southern California, University Park Campus, Los Angeles, California.
³ Baylor College of Medicine, Division of Adolescent Medicine and Sports Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.

PMID: 35346557
DOI: 10.1016/j.jadohealth.2022.01.226

Abstract

Purpose: Poorly planned healthcare transition (HCT) from pediatric to adult-based care for adolescents and young adults with special healthcare needs (AYASHCN) is associated with increased morbidity and mortality. Most pediatricians and pediatric residents are not trained to assist AYASHCN with HCT planning. An electronic medical record-based Transition Planning Tool (TPT) was developed at a large children's hospital to guide provider-patient interactions around HCT planning. The purpose of this study was to evaluate an educational intervention to promote residents' use of the TPT.

Methods: A multimodal (TPT training, demonstrations, use prompts, and case discussions) curriculum promoting the use of the TPT was developed and implemented within a one-month Adolescent Medicine Rotation. A prospective, nonrandomized, quasi-experimental design with Intervention and Historical Control groups was used. Forty-two residents received the intervention. Twenty-three Historical Control residents received minimal formal training in the TPT. Intervention Group residents completed prerotation/postrotation assessments measuring perceived importance of/comfort with HCT planning and self-reported HCT planning activities. TPT use was compared between the two groups.

Results: Compared to the Historical Control Group, Intervention Group residents were significantly more likely to use the TPT (98% vs. 37%, p < .001) and had a higher mean number of uses (5.5 ± 3.0 vs. 2.6 ± 1.2, p < .001). Residents reported greater perceived importance of (p < .001) and engagement in (p < .001) transition planning activities after completing the intervention. Nearly all (91%) reported that their training increased their comfort in HCT planning.

Conclusions: A targeted intervention improved pediatric residents' use of the TPT and HCT planning activities.

Keywords: Adolescents and young adults; Adult learning Theory; Chronic illness; Healthcare transition; Resident education; Transition planning tool.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adolescent Medicine*
Child
Curriculum
Humans
Internship and Residency*
Prospective Studies
Transition to Adult Care*
Young Adult