Improving Transition from Pediatric to Adult Care for Youth with Cerebral Palsy
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Abstract
Problem Statement: Over 90% of children diagnosed with cerebral palsy (CP) are expected to reach adulthood and will require transitional care services. Got Transition is a six-step, evidence- based transition program for youth with special health care needs, including CP. Inconsistent transition planning puts individuals with CP at risk for adverse health outcomes. A retrospective chart review in 2023 found that no patients between 12-14 years had documented transition planning discussions. Purpose: This quality improvement (QI) project aimed to implement Step 1 of the Got Transition Program and assess provider adherence to a best practice alert (BPA) in a specialty clinic for patients aged 12-14 diagnosed with CP. Methods: Prior to project implementation, a comprehensive written transition policy was developed based on evidence- based guidelines. Staff training sessions of fourteen outpatient clinic personnel using a PowerPoint presentation were completed. Additional one-on-one training sessions with five healthcare providers were held to reinforce understanding and adherence to the policy. Weekly audits of the process measures were used to assess workflow adherence. Run charts were used to demonstrate adherence to audit findings. BPA emails were used to facilitate transition policy discussions and improve documentation. Results: Of the eligible patients, 64.3% (n=36) received the transition policy discussion and a written copy. Due to time constraints and patient complexity, discussions were deferred in 22.2% (n=8) of cases. BPAs were provided in 76.2% (n=32) of encounters, and provider adherence to documenting transition policy discussion in the EHR was 80.9% (n=34). Conclusion: Implementing Step 1 of the Got Transition Program was associated with increased transition policy discussions, sharing, and documentation.
