Developing a specialty transition clinic: Inaugural clinical and financial operations.

Purpose: Few examples of hospital-wide transition programs have been presented in the literature and to date, we have no data on the clinical and financial operations of such services.

Design And Methods: A transition clinic, guided by Got Transition's Six Core Elements, was created for youth with moderate-to-high medical and psychosocial complexity (per Bob's Levels of Social Support scale). The clinic visit and transition readiness assessment (UNC TRANSITION Index) were billed fee-for-service or under a bundled payment managed care model.

Integrating transition readiness assessment into clinical practice: Adaptation of the UNC TRXANSITION index into the Cerner electronic medical record.

Purpose: To describe the process of developing, and evaluating the feasibility and acceptability of, an EMR-based transition readiness assessment.

Design And Methods: A Cerner-based version of the UNC TRANSITION Index was implemented across four pediatric subspecialty clinics: epilepsy, inflammatory bowel disease; type 1 diabetes, oncology survivorship. The feasibility was assessed by each's clinic's ability to meet form completion goals and their assessment rate.

Adult Provider Perspectives on Transition and Transfer to Adult Care: A Multi-Specialty, Multi-Institutional Exploration.

Purpose: To identify barriers that transcend multiple adult care specialties and identify potential solutions.

Design And Methods: Twenty-one adult care providers practicing in the specialty areas of internal medicine, family medicine, gastroenterology, endocrinology, and neurology participated in one of six semi-structured focus group interviews. Data were coded and analyzed according to the Socio-ecological Model of Adolescent/Young Adult Readiness for Transition (SMART).