Abstracts

Rationale: In 2016, 15% of adolescents with and without special needs received guidance on transition from their health care providers. To increase clinicians’ provision of health care transition (HCT) services for youth with epilepsy, AAP’s National Coordinating Center for Epilepsy (NCCE) and The National Alliance to Advance Adolescent Health’s Got Transition program collaborated to improve the implementation of the Six Core Elements of HCT in seven programs across the country that included pediatric and adult neurology centers and primary care practices (PCP). Methods: As part of a federal grant, the seven programs implemented the 6 Core Elements through a learning collaborative approach over a three-year period. In the third year, the AAP NCCE surveyed the programs via an electronic questionnaire, with questions across 3 domains. Using a “least challenging” to “most challenging” scale, programs were asked to rank: 1) 8 issues for general HCT quality improvement (QI) improvements, 2) 10 issues for pediatric practices related to HCT implementation, 3) 10 issues for adult practices related to HCT implementation. Open ended questions were also included from responders for their clinics. Results: The survey was sent to 35 representatives from the seven programs. 13 responses were received (response rate 38%). The most challenging general issues related to HCT implementation were incorporating HCT into Electronic Medical Records (EMR) (62%) and identifying adult PCPs (38%). For pediatric practices, obtaining leadership buy-in (46%), having time alone (38%), building connections with adult clinicians (38%) were most challenging. For adult practices, incorporating HCT into EMR (62%), senior leadership buy in (46%), obtaining payment and developing welcoming and orientation information (each at 38%) were identified as most challenging issues. Conclusions: Clinician feedback is a critical, but often an overlooked component of measurement in HCT. Addressing these challenges is important to enable structured and sustainable HCT processes in programs. Funding: This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U23MC26252, Awareness and Access to Care for Children and Youth with Epilepsy/cooperative agreement. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.