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Transition of Care in Congenital Heart Disease: Ensuring the Proper Handoff

  • Congenital Heart Disease (RA Krasuski, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Background

With great advances in medical and surgical care, most congenital heart disease patients are living in to adulthood and require lifelong surveillance and expert care for adult onset complications. Care lapse and lack of successful transfer from pediatric to adult care put young adults at risk for increased morbidity and premature death. Hence, transition and transfer from pediatric to adult care is a crucial and critical process to provide access to specialized care and lifelong surveillance.

Purpose of Review

The aim of this article is to describe barriers to successful transition and transfer and to share practical strategies and concepts to overcome these barriers in order to successfully implement a transition program.

Recent Findings

There are patient-specific, local, and institutional specific barriers to establish a successful transition program which involves many stakeholders. Collaboration of the Pediatric and Adult Congenital Heart Disease programs is paramount; the understanding of the benefit and the need of a structured transition program, dedication, and a proactive approach are essential. Youth- and family-centered education improves healthcare knowledge, self-management, self-advocacy, and appropriate interdependence and helps young adults to take ownership of their health.

Summary

Nurses play an integral role within the multidisciplinary team in supporting seamless, successful transition and transfer of CHD patients from pediatric to adult care thereby reducing loss to follow-up and lapses in care. Most experiences and recommendations are based on retrospective studies and expert consensus. It is imperative to evaluate the impact of structured and planned transition/transfer programs on the outcomes. Hence, prospective, randomized trials are required to document if implementation of structured intervention transition programs improve knowledge, patient experiences, and outcomes of congenital heart defect survivors.

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Acknowledgments

We acknowledge the contribution from Ms. Suzanne Hemeon, Clinical Coordinator from the University Health Network/Toronto General Hospital, Ambulatory Cardiology Unit as she is the liaison between cardiologists, fellows, nurses, allied health professionals, patients, and their family members. Suzanne helps to triage the new congenital referrals, search for lost to follow-up patients, and coordinate complex medical appointments. She coordinates the transition referral process and makes it as seamless as possible. The authors are in debt to the members of the Toronto Transition Task Force (established in 2008) for their great collaboration, support, and input to provide a seamless transition and transfer from pediatric to adult care. The authors are extremely grateful to Ms. Cathy Chau, Adult Congenital Heart Disease Program Administrator, for her generous administrative support and editing this manuscript. Dr. Erwin Oechslin presently holds the Bitove Family Professorship of Adult Congenital Heart Disease.

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Author notes

  1. Angela Lee and Barbara Bailey contributed equally to this article and are shared first authors.

Authors and Affiliations

  1. Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, 585 University Avenue, 5N-519, Toronto, ON, M5G 2N2, Canada

    Angela Lee, Barbara Bailey & Erwin Oechslin

  2. Division of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada

    Geraldine Cullen-Dean

  3. Labatt Family Health Centre, The Hospital for Sick Children, Toronto, ON, Canada

    Sandra Aiello & Erwin Oechslin

  4. University of Ottawa Heart Institute, Ottawa, ON, Canada

    Joanne Morin

Authors
  1. Angela Lee
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  2. Barbara Bailey
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  3. Geraldine Cullen-Dean
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  4. Sandra Aiello
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  5. Joanne Morin
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  6. Erwin Oechslin
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Corresponding author

Correspondence to Erwin Oechslin.

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Conflict of Interest

Angela Lee, Barbara Bailey, Geraldine Cullen-Dean, Sandra Aiello, Joanne Morin, and Erwin Oechslin declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Congenital Heart Disease

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Lee, A., Bailey, B., Cullen-Dean, G. et al. Transition of Care in Congenital Heart Disease: Ensuring the Proper Handoff. Curr Cardiol Rep 19, 55 (2017). https://doi.org/10.1007/s11886-017-0859-5

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  • DOI: https://doi.org/10.1007/s11886-017-0859-5

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