Success Through Transition: A Transition Planning Checklist for Diabetes Care Transition
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Abstract
Adolescence is one the most challenging stages for a person with Type 1diabetes. Despite the significant importance of tailoring healthcare services to adolescents’ unique needs including their rapid psychosocial growth and development, high quality adolescent healthcare services are not universal in the United States. The current system of health services is ill suited for providing the proper mix of clinical and preventative services to youth. According to the Consensus Statement on Health Care Transition for Young Adults with Special Health Care Needs, “each year more than half a million children with disabilities and chronic illness transition from adolescence into adulthood”.
In response to the need for transition care the National Diabetes Education Program transition-planning checklist was adapted and implemented for use with youth ages 16-22 years in a primary care clinical practice to provide a more structured process in healthcare transition planning for providers and patients.
The project took place at Sanford Health children’s diabetes department in Fargo, North Dakota from July 2015 through December 2015. The checklist was used by healthcare providers to introduce the concept of transition and topics important to successful transition in the future. After implementation, use of the tool with qualified patients and evaluation of provider feedback about the checklist was used to improve utility of the evidence-based checklist in practice application for future use.
Across six months of implementation, 25% of all eligible youth with Type 1 diabetes seen were presented the transition-planning checklist. The providers agreed the transition-planning checklist incorporated good structure and content. All providers desired to continue to use the checklist in the future to provide transition-planning care to youth with Type 1 diabetes. Providing holistic care for youth with Type 1 diabetes is important for successful transition to adult care services. Implementing a transition –planning checklist in the children’s diabetes department was found to be helpful and well received despite limited use (25% of eligible patients). Future efforts should be made to extend the project to be more inclusive of all areas needed for successful transition.