The ACP Pediatric to Adult Care Transitions Toolkit contains disease-specific tools that are critical for the young adult in transition to be aware of and understand in order to successfully achieve optimal self-care as an emerging adult.
Each set of tools was required to include at least the three minimum elements described below, which have been customized to include disease/condition-specific elements that are an important part of the transition process for emerging adults in learning self-care. Practices utilizing these tools should also consider incorporating some of the generic tools from the Got Transition Six Core Elements in establishing a process and procedures for pediatric patient transitioning to adult care. The disease/condition-specific sets of tools found below on this page contain the following customized elements, at a minimum:
- Transition Readiness Assessment – an assessment tool intended to be utilized by the pediatric care team or other clinicians caring for youth to begin the conversation about the youth’s needed skills to manage their health and health care. The tool is used to evaluate the youth’s current knowledge about and ability to manage his/her health condition. This tool indicates the elements specifically related to the clinical condition that should be assessed and documented by the transferring pediatric practice. This tool can be revisited and utilized as a teaching and training aid to ensure that these items have been mastered by the time the young adult is ready to transfer to adult care.
- Medical Summary/Transfer Record – a summary of the key medical record elements that contains the essential information needed for communication between pediatric and adult clinicians for the specific patient including pertinent disease-specific information. This is to be completed by the pediatric or other sending clinician, shared with the youth and family and sent to the receiving adult clinician.
- Self-Care Assessment – an assessment tool to be utilized by the adult care team to assess any remaining gaps in self-care knowledge and skills or additional issues that need to be addressed to ensure optimal management of the medical condition(s).
Sets of tools are currently available for the following subspecialties and diseases (with more to be added over time):
General Internal Medicine
- Inflammatory Bowel Disease (Coming soon!)