healthcare transition: getting on the same page peter scal, md mph department of pediatrics...
TRANSCRIPT
Healthcare Transition: Getting on the Same Page
Peter Scal, MD MPHDepartment of PediatricsUniversity of Minnesota
July 21, 2012
All to common comment…..
“I have 17 year old identical twin daughters with spastic cerebral palsy. We have received no assistance in the transition from pediatric to adult health care services. Everything we have set up has been parent initiated”
Learning Objectives
You should be able to: Describe the goals of health care
transition Locate and begin using HCT specific
resources and tools Understand how to incorporate HCT into
every healthcare visit
The goal….
“is to maximize lifelong functioning and well-being…
by ….. ensuring that high-quality, developmentally appropriate health care
…..uninterrupted as the person moves from adolescence to adulthood”
Working Definition of HCT Counseling:Process of supporting teens and their parents develop the –
Skills
Resources
Motivation
-to reduce the impact their chronic health condition on their everyday activities and future opportunities
HCT is a Process not an event:
Begins early…at time of diagnosis
Stepwise…building skills over time
Meets the needs of teens, families AND healthcare providers. (no single right way)
Transfer of care is only ONE (important) element of a successful transition….
Building Internal Motivation: by meeting basic needs
Competence Ability to have an impact and
change a behavior
Autonomy Behavior is volitional or
undertaken by choice
Relatedness Feeling cared for and caring for
others
Coming Next ?
Web-based assessment and self-management tools (integrated into EMR or stand-alone)
EMR Templates Quality Measures specific and related to
HCT Training for ‘adult practitioner’ in
One Day?
“My 22 year old multiply disabled technology dependent daughter transitioned successfully from a pediatric practice last year. This was an emotional and traumatic change for me, her mother. I was grateful to be referred to Dr. X. She had a pediatric and internal medicine background she made the proper referrals … and counseled us …
….I am impressed with the time spent with us at appointments and the fact that she answers all of my questions, and some I never even thought to ask! I now refer other parents in the transition process to Dr. X in hopes that they may also experience a successful transition in their primary health care provider.”
Pediatrics 2011;128:182-200
©2011 by American Academy of Pediatrics
Health care transition-planning
algorithm for all youth and young adults within a medical home interaction.
Add a motivational approach
Motivational interviewing Patient centered style aimed at resolving
ambivalence Self-Determination
Foster intrinsic motivation