Transition in Healthcare: Importance and Outcomes
Transition in healthcare is a multifaceted active process that involves creating individualized plans suitable for all ages. It merges pediatric and adult services to equip young adults with tools for managing their long-term health needs. The process aims to improve overall health, enhance patient expertise, and develop healthcare services. Results from an audit showed positive feedback, highlighting the significance of discussing and planning transitions prior to transferring to adult services.
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Transitional / YAJIA clinic Freeman Hospital Dr Martin Lee & SPN Lesley Tiffin
Transition What is it? Multifaceted active process. Individualised agreed plan that is age and developmentally appropriate. Includes both Paediatric and Adult Services
Transition Why is it important? Equip our Young Adults with the tools to manage their long term health needs. Expert Patient Improve and develop health services in the NHS. Improve overall health of Young People.
Your Welcome (DoH, 2010) Evidence based / Quality Criteria Self Review Workbook / Accredited 10 principles Active and effective participation of Young People in monitoring and evaluation of their health services
Audit 2 questionnaires: 1stquestionnaire developed for our service 2ndquestionnaire DOH Your Welcome 27 participants / service users 3 months (3 YAJIA clinics) 12 Male Patients (aged 16-23, median 19 years) 15 Female Patients (aged 16-25, median 19 years)
Results: Questionnaire 1 Largely very favourable! Transition and concerns discussed and planned prior to transfer to Adult Services (85 95%) Meeting the Adult Team
If you did meet Dr Martin Lee or Lesley Tiffin (Rheumatology Specialist Nurse) at the GNCH prior to your transfer to the Freeman Hospital, did you find this helpful (ie. did you find it reassuring?) 16 14 12 10 8 6 4 2 0 Yes No N/A
If you did not meet Dr Martin Lee or Lesley Tiffin (Rheumatology Specialist Nurse) at the GNCH prior to your transfer to the Freeman Hospital clinic, would you have found this helpful (ie. would you have found this reassuring?) 10 9 8 7 6 5 4 3 2 1 0 Yes No N/A
Comments The transfer period worked very well. Due to me wanting to attend university, it was discussed and held back until I knew where I was attending in order to reduce unnecessary stress (moving services from children to adult, then possibly moving to another part of the country etc.) When I was first asked about moving up I was very cautious so Dr x gave me longer to decide and kept reassuring me about it. I then met Dr y but was still told that I didn t have to move if I didn t want to but that meeting really helped and everyone at the Freeman is welcoming and helped with just things like finding my way round.
Results: Questionnaire 2 (DoH Your Welcome) Largely very favourable! Domain 1.5 (accessibility of service) (89-100% positive) Domain 4.1 (safe, suitable, friendly service) (81-96% positive)
If you asked about pregnancy options, abortion, sexual health or contraception, did the staff member try to make you feel comfortable, relaxed and not embarrassed? 16 14 12 10 8 6 4 2 0 Yes No N/A
Would you be happy to use the service again? 25 20 15 10 5 0 Yes No N/A
Would you encourage your friends to use this service? 25 20 15 10 5 0 Yes No N/A
Overall, how did you feel about your experience of using the service? (Rate on scale of 1 to 5, with 5 as excellent) 18 16 14 12 10 8 6 4 2 0 1 2 3 4 5 N/A
Favourable Comments Everyone was very helpful and friendly The service is easily accessible, helpful and fit for purpose Friendly and very informative It was a very welcoming environment Easy access, friendly staff, very welcoming Treat more like an adult Helpful and questions you have ask are answered Good doctors and nurses I feel very comfortable using this service
Areas that scored low (Areas and opportunities that we can work on prior to re-auditing and applying for Your Welcome) Domain 3.1 / 3.3 (understanding of confidentiality) Domain 7.2 (how to make comments, complaints, suggestions and feedback on young person involvement ie you said, we did ) Domain 1.8 (information on display regarding religion, sexuality, mental health)
How do we improve things? Continue to develop links with GNCH and attend transfer clinics Explain understanding of confidentiality (appointment letter, leaflets) Explain how make comments, complaints or suggestions and feedback (you said, we did) Work on display board with information on local health services, religion, sexuality and local health (HEADSSS)
SWOT Analysis Strengths: Motivated team (EULAR course / Diploma Adol Health) Networks (BANNAR / EuTEACH / NEAR / BSPAR / NRAS JIA) DoH Weaknesses: Infrastructure MDT (Psychology / OT / Phyiso) Experience
SWOT Analysis Opportunities: New build Database Research (YOURR / LYNC / UCB / BANNAR) E-communication / Advertise service Threats: Time (Clinical / Admin / Volume) Succession / Illness
The Future Do we have a YA friendly service? Infrastructure Transition service GNCH to FH New referrals 14-16, 16-25? Other conditions (CTD / SpA / Gastro / Derm) Plans: You re Welcome Involving YA in research (YOURR / LYNC / BANNAR) Infrastructure Database
