Differences in Health Care Transition Views, Practices, and Barriers Amongst North American Pediatric Rheumatology Clinicians from 2010 to 2018

2021 ◽  
pp. jrheum.200196 ◽  
Author(s):  
Kiana Johnson ◽  
Cuoghi Edens ◽  
Rebecca E. Sadun ◽  
Peter Chira ◽  
Aimee O. Hersh ◽  
...  
Keyword(s):  
Health Care ◽  
Pediatric Rheumatology ◽  
Primary Care Providers ◽  
Care Transition ◽  
Care Providers ◽  
Transition Processes ◽  
Health Care Transition ◽  
Healthcare Transition ◽  
Transition Clinic ◽  
Current Assessment

Objective Since 2010, the rheumatology community has developed guidelines and tools to improve healthcare transition . In this study we aimed to compare current transition practices and beliefs among Childhood Arthritis and Rheumatology Research Alliance (CARRA) rheumatology providers with transition practices from a 2010 provider survey published by Chira et al. Methods In 2018, CARRA members completed a 25-item online survey about healthcare transition. Got Transition’s™ Current Assessment of Health Care Transition Activities was used to measure clinical transition processes on a scale of 1 (basic) to 4 (comprehensive). Bivariate analyses were used to compare 2010 and 2018 survey findings. Results Over half of CARRA members completed the survey (217/396), including pediatric rheumatologists, adult- and pediatric-trained rheumatologists, pediatric rheumatology fellows, and advanced practice providers. The most common target age to begin transition planning was 15-17 (49%). Most providers transferred patients prior to age 21 or older (75%). Few providers used the American College of Rheumatology transition tools (31%) or have a dedicated transition clinic (23%). Only 17% had a transition policy in place, and 63% did not consistently address healthcare transition with patients. When compared to the 2010 survey, improvement was noted in three of twelve transition barriers: availability of adult primary care providers, availability of adult rheumatologists, and pediatric staff transition knowledge and skills (p<0.001 for each). Nevertheless, the mean Current Assessment score was less than 2 for each measurement. Conclusion This study demonstrates improvement in certain transition barriers and practices since 2010, although implementation of structured transition processes remains inconsistent.

Teaching Adolescents to Manage Their Own Health Care

2019 ◽  
pp. 105984051986736
Author(s):  
Chelsea J. Aeschbach ◽  
William B. Burrough ◽  
Amy B. Olejniczak ◽  
Erica R. Koepsel
Keyword(s):  
Health Care ◽  
High School Students ◽  
Health Care Providers ◽  
Health Care Services ◽  
Transition Process ◽  
Care Transition ◽  
Care Providers ◽  
School Students ◽  
Health Care Transition ◽  
Care Services

Many factors impact an adolescent’s willingness to appropriately use health-care services and intent to begin the health-care transition process. Published literature continues to show that the way adolescents experience and utilize health-care services is ineffective and has long-term impacts on individuals and systems. Building upon the success of an existing peer-to-peer workshop, a Toolkit was created to provide school-based health professionals the information and resources needed to deliver pertinent information to high school students in one lesson. Of 416 students, over two thirds reported that they plan to be more involved in their health care (69.8%), advocate for themselves in health-care settings (68.0%), talk openly and honestly with health-care providers (71.9%), and learn more about managing their own health care (68.6%). Integrating this information into existing health curricula provided a broader reach with minimal work and promising results that could improve overall health-care transition efforts.

Health Care Transition in School-Based Health Centers: A Pilot Study

2020 ◽  
pp. 105984052097574
Author(s):  
Patience H. White ◽  
Samhita M. Ilango ◽  
Ana M. Caskin ◽  
Maria G. Aramburu de la Guardia ◽  
Margaret A. McManus
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Self Care ◽  
Health Centers ◽  
Care Transition ◽  
Care Providers ◽  
Health Care Transition ◽  
School Based ◽  
Core Elements ◽  
School Based Health Centers

Nationally, there are low rates of high school–age youth receiving health care transition (HCT) preparation from health care providers. This pilot study implemented and assessed the use of a structured HCT process, the Six Core Elements of HCT, in two school-based health centers (SBHCs) in Washington, DC. The pilot study examined the feasibility of incorporating the Six Core Elements into routine care and identified self-care skill gaps among students. Quality improvement methods were used to customize, implement, and measure the Six Core Elements and HCT supports. After the pilot, both SBHCs demonstrated improvement in their implementation of the structured HCT process. More than half of the pilot participants reported not knowing how to find their doctor’s phone number and not knowing what a referral is. These findings indicate the need for incorporating HCT supports into SBHCs to help students build self-care skills necessary for adulthood.

scholarly journals Using meta-ethnography to understand the care transition experience of people with dementia and their caregivers

Dementia ◽  
2021 ◽  
pp. 147130122110317
Author(s):  
Marianne Saragosa ◽  
Lianne Jeffs ◽  
Karen Okrainec ◽  
Kerry Kuluski
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Quality Care ◽  
Care Transitions ◽  
Poor Quality ◽  
Empirical Literature ◽  
Care Transition ◽  
Health Care Transition ◽  
Healthcare Transition ◽  
People With Dementia

Older adults living with dementia are at risk for more complex health care transitions than individuals without this condition, non-impaired individuals. Poor quality care transitions have resulted in a growing body of qualitative empirical literature that to date has not been synthesized. We conducted a systematic literature review by applying a meta-ethnography approach to answer the following question: How do older adults with dementia and/or their caregivers experience and perceive healthcare transition: Screening resulted in a total of 18 studies that met inclusion criteria. Our analysis revealed the following three categories associated with the health care transition: (1) Feelings associated with the healthcare transition; (2) processes associated with the healthcare transition; and (3) evaluating the quality of care associated with the health care transition. Each category is represented by several themes that together illustrate an interconnected and layered experience. The health care transition, often triggered by caregivers reaching a “tipping point,” is manifested by a variety of feelings, while simultaneously caregivers report managing abrupt transition plans and maintaining vigilance over care being provided to their family member. Future practice and research opportunities should be more inclusive of persons with dementia and should establish ways of better supporting caregivers through needs assessments, addressing feelings of grief, ongoing communication with the care team, and integrating more personalized knowledge at points of transition.

Beliefs About Health Care Transition in Pediatric Thoracic Organ Transplant

2010 ◽  
Author(s):  
Cindy L. Buchanan ◽  
Debra Lefkowitz ◽  
Karen McCandless ◽  
Samuel Goldfarb
Keyword(s):  
Health Care ◽  
Organ Transplant ◽  
Care Transition ◽  
Health Care Transition ◽  
Thoracic Organ

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI &lt; 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI&gt;14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

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