Perceptions of Youth-Adult Transition in Hospital Care Activities at US Children’s Hospitals

Core ElementSpecific Inpatient Transition ActivityImportance, Mean (SD)Feasibility, Mean (SD)
Transition policy that includes the inpatient transition4.0 (0.8)3.6 (0.9)
Tracking and monitoring
Proactive identification of patients anticipated to need transition4.5 (0.7)3.8 (0.8)
Proactive identification of patients overdue for inpatient transition4.5 (0.7)3.8 (0.8)
Formal assessment of transition readiness4.0 (0.8)3.4 (0.8)
Transition timing discussed with youth or family4.5 (0.7)3.7 (0.7)
Transition education provided to family3.9 (0.9)3.3 (1.0)
Communication differences between pediatric and internal medicine providers reviewed with families4.1 (0.9)3.4 (0.9)
Transition care plan created with needs and long-term therapeutic goals created4.2 (0.7)3.4 (1.0)
Transition care plan provided to the patient and/or family4.3 (0.7)3.6 (1.0)
Care conference between pediatric and internal medicine providers3.6 (1.0)2.8 (1.1)
Agreement on inpatient transition timing achieved between primary care and subspecialists4.2 (0.7)3.1 (1.0)
Agreement on inpatient transition timing achieved among subspecialists4.3 (0.8)3.1 (1.0)
Ability for medical decision-making established3.8 (1.1)3.4 (0.9)
Insurance problems addressed4.2 (0.8)3.5 (1.0)
Patient and/or family informed subsequent stays will be at adult inpatient facility4.5 (0.7)3.9 (0.8)
Adult inpatient facility toured3.3 (1.0)3.1 (1.1)
Transfer of care
Standardized handoff communicated between pediatric and internal medicine providers4.2 (0.7)3.2 (0.9)
Transition checklist used to complete tasks3.9 (0.8)3.6 (0.9)
Patient and/or family meet inpatient adult care team3.5 (1.1)2.8 (1.1)
Transfer completion
Pediatric provider and patient and/or family interaction during first nonpediatric stay3.1 (1.1)3.1 (1.0)
Child life consult during first nonpediatric stay2.8 (1.2)3.0 (1.3)
  • As part of a larger quality improvement initiative at our institution, a multidisciplinary team developed an ideal-state inpatient transition experience within a children’s hospital for adults’ CCOCs. To facilitate description, these were categorized by using labels from the Six Core Elements Framework. Ratings were as follows: 1 = not at all, 2 = a little, 3 = somewhat, 4 = very, and 5 = extremely.