Healthcare Transition from the Pediatric Provider’s Perspective

  • Cecily L. Betz


This chapter provides an overview of the pediatric provider’s perspective on healthcare transition planning. Barriers encountered in developing and implementing HCT services and programs will be discussed. Strategies to confront these barriers to effect the implementation of services will be addressed.


Transfer of care Providers Medical summary Clinical guidelines 


  1. 1.
    Magrab PR, Miller, H.E.C., editor Surgeon’s General’s Conference: Growing up and getting medical care: Youth with special health care needs. A summary of conference proceedings. Surgeon’s General’s Conference: Growing up and getting medical care: Youth with special health care needs A summary of conference proceedings; 1989 March 13–15, 1989; Jekyll Island, Georga: National Center for Networking Community Based Services. Georgetown University Child Development Center.Google Scholar
  2. 2.
    Betz CL, O’Kane LS, Nehring WM, Lobo ML. Systematic review: Health care transition practice service models. Nurs Outlook. 2016;64(3):229–43. PubMed PMID: 26992949.PubMedCrossRefGoogle Scholar
  3. 3.
    Bloom SR, Kuhlthau K, Van Cleave J, Knapp AA, Newacheck P, Perrin JM. Health care transition for youth with special health care needs. J Adolesc Health. 2012;51(3):213–9. PubMed PMID: 22921130. English.PubMedCrossRefGoogle Scholar
  4. 4.
    Campbell F, Biggs K, Aldiss SK, O'Neill PM, Clowes M, McDonagh J, et al. Transition of care for adolescents from paediatric services to adult health services. Cochrane Database Syst Rev. 2016;4:CD009794. PubMed PMID: 27128768.PubMedGoogle Scholar
  5. 5.
    Chu PY, Maslow GR, von Isenburg M, Chung RJ. Systematic Review of the Impact of Transition Interventions for Adolescents With Chronic Illness on Transfer From Pediatric to Adult Healthcare. J Pediatr Nurs. 2015;30(5):e19–27. PubMed PMID: 26209872. Pubmed Central PMCID: NIHMS710745.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Nehring WM, Betz CL, Lobo ML. Uncharted Territory: Systematic Review of Providers' Roles, Understanding, and Views Pertaining to Health Care Transition. J Pediatr Nurs. 2015;30(5):732–47. PubMed PMID: 26228310.PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Okumura MJ, Heisler M, Davis MM, Cabana MD, Demonner S, Kerr EA. Comfort of general internists and general pediatricians in providing care for young adults with chronic illnesses of childhood. J Gen Intern Med. 2008;23(10):1621–7. PubMed PMID: 18661191.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Okumura MJ, Kerr EA, Cabana MD, Davis MM, Demonner S, Heisler M. Physician views on barriers to primary care for young adults with childhood-onset chronic disease. Pediatrics. 2010;125(4):e748–54. PubMed PMID: 20231189.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians, Transitions Clinical Report Authoring G, Cooley WC, Sagerman PJ. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011;128(1):182–200. PubMed PMID: 21708806.CrossRefGoogle Scholar
  10. 10.
    American College of Physicians. Guidelines and Tools Developed for Pediatric-to-Adult Health Care Transitions Initiative. 2016.
  11. 11.
    National Institute for Health and Clinical Excellence (NICE). Autism: Recognition, referral, diagnosis and management of adults on the autism spectrum. London (UK): National Institute for Health and Clinical Excellence (NICE); 2012. 57, Clinical guideline, no. 142.
  12. 12.
    Yankaskas JR, Marshall BC, Sufian B, Simon RH, Rodman D. Cystic fibrosis adult care: Consensus conference report. Chest. 2004;125(1 Suppl):1S–39S.PubMedCrossRefGoogle Scholar
  13. 13.
    Pediatric Complex Care Association. Children and Young Adults with Medical Complexity: Serving an Emerging Population. 2016.
  14. 14.
    National Heart Lung, and Blood Institute. Evidence-Based Management of Sickle Cell Disease: Expert Panel Report, 2014. 2014.
  15. 15.
    Centers for Disease Control and Prevention. Living with Spina Bifida. 2016.
  16. 16.
    Al-Yateem N. Child to adult: transitional care for young adults with cystic fibrosis. Br J Nurs. 2012;21(14):850–4. PubMed PMID: 23252167. English.PubMedCrossRefGoogle Scholar
  17. 17.
    Camfield PR, Gibson PA, Douglass LM. Strategies for transitioning to adult care for youth with Lennox Castuat syndrome and related disorders. Epilepsia. 2011;5(Suppl. 5):21–7.CrossRefGoogle Scholar
  18. 18.
    Collins SW, Reiss J, Saidi A. Transition of care: what is the pediatric hospitalist’s role? An exploratory survey of current attitudes. J Hosp Med. 2012;7(4):277–81. PubMed PMID: 22125023.PubMedCrossRefGoogle Scholar
  19. 19.
    McDonagh JE, Southwood TR, Shaw KL, Bristish Paediatric Rheumatology G. Unmet education and training needs of rheumatology health professionals in adolescent health and transitional care. Rheumatology. 2004;43(6):737–43.PubMedCrossRefGoogle Scholar
  20. 20.
    LoCasale-Crouch J, Johnson B. Transition from pediatric to adult medical care. Adv Chronic Kidney Dis. 2005;12(4):412–7. PubMed PMID: 16198281.PubMedCrossRefGoogle Scholar
  21. 21.
    Patel MS, O’Hare K. Residency training in transition of youth with childhood-onset chronic disease. Pediatrics. 2010;126(2):S190–S3.PubMedCrossRefGoogle Scholar
  22. 22.
    Suris JC, Akre C, Rutishauser C. How adult specialists deal with the principles of a successful transition. J Adolesc Health. 2009;45(6):551–5.PubMedCrossRefGoogle Scholar
  23. 23.
    McPheeters M, Davis AM, Taylor JL, Brown RF, Potter SA, Epstein RA. Transition care for children with special health needs. Technical brief No. 15. Rockville, MD: Agency for Healthcare Research and Quality Prepared by the Vanderbilt University Evidence-based Practice Center under Contract No. 290–2012–00009-1; 2014.Google Scholar
  24. 24.
    Peter NG, Forke CM, Ginsburg KR, Schwarz DF. Transition from pediatric to adult care: internists' perspectives. Pediatrics. 2009;123(2):417–23.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Murphy DJ Jr, Foster E, American College of Cardiology Foundation, American Heart Association, American College of Physicians Task Force on Clinical Competence. ACCF/AHA/AAP recommendations for training in pediatric cardiology. Task force 6: training in transition of adolescent care and care of the adult with congenital heart disease. J Am Coll Cardiol. 2005;46(7):1399–401. PubMed PMID: 16198870.PubMedCrossRefGoogle Scholar
  26. 26.
    Fernandes SM, Khairy P, Fishman L, Melvin P, O’Sullivan-Oliveira J, Sawicki G, et al. Referral patterns and perceived barriers to adult congenital heart disease care: Results of a survey of U.S. pediatric cardiologists. J Am Coll Cardiol. 2011;60(23):2411–8.CrossRefGoogle Scholar
  27. 27.
    Ubel P. Why Many physicians are reluctant to see Medicaid patients. Forbes. 2013;Google Scholar
  28. 28.
    American Medical Association. Report of the Council on Medical Service. Chicago, Illinois; 2016.Google Scholar
  29. 29.
    McManus MM, R. Practice Resource-No.2, 2017 Coding and Reimbursement Tip Sheet for Transition from Pediatric to Adult Health Care Washington, D.C: Got Transition and American Academy of Pediatrics. 2016.
  30. 30.
    Betz CL, Nehring WM, Lobo ML. Transition Needs of Parents of Adolescents and Emerging Adults With Special Health Care Needs and Disabilities. J Fam Nurs. 2015;21(3):362–412. PubMed PMID: 26283056.PubMedCrossRefGoogle Scholar
  31. 31.
    Betz CL, Lobo ML, Nehring WM, Bui K. Voices not heard: a systematic review of adolescents’ and emerging adults’ perspectives of health care transition. Nurs Outlook. 2013;61(5):311–36. PubMed PMID: 23876260.PubMedCrossRefGoogle Scholar
  32. 32.
    Fernandes S, Fishman L, O’Sullivan-Oliveira J, Ziniel S, Melvin P, Khairy P, et al. Current practices for the transition and transfer of patients with a wide spectrum of pediatric-onset chronic diseases: Results of a clinician survey at a free-standing pediatric hospital. Int J Child Adolesc Health. 2012;3:507–15.Google Scholar
  33. 33.
    Gilliam PP, Ellen JM, Leonard L, Kinsman S, Jevitt CM, Straub DM. Transition of adolescents with HIV to adult care: Characteristics and current practices of the adolescent trials network for HIV/AIDS interpretation. J Assoc Nurses AIDS Care. 2011;22(4):283–94.PubMedCrossRefGoogle Scholar
  34. 34.
    Clarizia NA, Chahal N, Manlhiot C, Kilburn J, Redington AN, McCrindle BW. Transition to adult health care for adolescents and young adults with congenital heart disease: Perspectives of the patient, parent and health care provider. Can J Cardiol. 2009;25(9):e317–e22.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Betz CL, Smith KA, Van Speybroeck A, Hernandez FV, Jacobs RA. Movin’ On Up: An Innovative Nurse-Led Interdisciplinary Health Care Transition Program. J Pediatr Health Care. 2016;30(4):323–38. PubMed PMID: 26483330.PubMedCrossRefGoogle Scholar
  36. 36.
    Society of Pediatric (SPN). SPN Position Statement: Transition of Pediatric Patients into Adult Care. Chicago, Illinois: Society of Pediatric Nurses; 2016. p. 9.Google Scholar
  37. 37.
    Coyne B, Hallowell SC, Thompson M. Measurable Outcomes After Transfer From Pediatric to Adult Providers in Youth With Chronic Illness. J Adolesc Health. 2017;60(1):3–16. PubMed PMID: 27614592.PubMedCrossRefGoogle Scholar
  38. 38.
    Lotstein DS, McPherson M, Strickland B, Newacheck PW. Transition planning for youth with special health care needs: results from the National Survey of Children With Special Health Care Needs. Pediatrics. 2005;115(6):1562–8. PubMed PMID: 2009019696.PubMedCrossRefGoogle Scholar
  39. 39.
    Prior M, McManus M, White P, Davidson L. Measuring the “triple aim” in transition care: a systematic review. Pediatrics. 2014;134(6):e1648–61. PubMed PMID: 25422015.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PediatricsUniversity of Southern California (USC), Keck School of MedicineLos AngelesUSA
  2. 2.USC University Center for Excellence in Developmental Disabilities, Children’s Hospital Los AngelesLos AngelesUSA

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