From pediatric to adult care: strategic evaluation of a transition program for patients with osteogenesis imperfecta

Achieving a successful transition from pediatric to adult care for young adults with special needs, especially rare genetic diseases such as osteogenesis imperfecta (OI), is a prominent issue in healthcare research. This transition represents a challenge for patients with OI, their families, clinici...

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Veröffentlicht in:BMC health services research 2014-10, Vol.14 (1), p.489-489, Article 489
Hauptverfasser: Dogba, Maman Joyce, Rauch, Frank, Wong, Trudy, Ruck, Joanne, Glorieux, Francis H, Bedos, Christophe
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Bedos, Christophe
description Achieving a successful transition from pediatric to adult care for young adults with special needs, especially rare genetic diseases such as osteogenesis imperfecta (OI), is a prominent issue in healthcare research. This transition represents a challenge for patients with OI, their families, clinicians and healthcare managers because of the complex nature of the process and the lack of evaluation of existing transition programs. We evaluated a transition program for adolescents and young adults with OI from a pediatric orthopedic hospital to adult care. Data were collected by interview, observation, and document review from April 2013 to October 2013. Participants included six patients with OI, four parents, and 15 staff, including administrators, coordinators, social workers, nurses, pediatricians, surgeons, occupational therapists and physiotherapists. A SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis was performed. The strengths of the transition program included a solid theoretical approach based on a partnership with parents, and a comprehensive transition model based on fostering independent living and professional integration. The program's main weaknesses were the successive organizational changes and discontinuation of certain transition activities, and the potential conflict between the transition program and participation in research protocols. Further opportunities include the implementation of a multi-site transition model with cross-site personnel and user evaluations, with the inclusion of second-generation patients. Dissatisfaction reported by some care-team members at the adult care hospital could threaten collaboration among institutions involved in the transition process, whereas dissatisfaction of some former patients may reduce their perceptions of quality of care received during the transition. This study confirmed that a "one-size-fits-all" transition model for patients with OI would be inappropriate across, or even within institutions. Opportunities should be seized to create tailored, theoretically-sound transition programs that reflect patient preferences, especially those of young adults with complex and chronic health conditions. Alignment with other organizational activities should be considered, and ongoing evaluation of transition programming may be required. This SWOT analysis and utilization-focused evaluation has led to a comprehensive new project to improve the transition program for patients with OI and
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The program's main weaknesses were the successive organizational changes and discontinuation of certain transition activities, and the potential conflict between the transition program and participation in research protocols. Further opportunities include the implementation of a multi-site transition model with cross-site personnel and user evaluations, with the inclusion of second-generation patients. Dissatisfaction reported by some care-team members at the adult care hospital could threaten collaboration among institutions involved in the transition process, whereas dissatisfaction of some former patients may reduce their perceptions of quality of care received during the transition. This study confirmed that a "one-size-fits-all" transition model for patients with OI would be inappropriate across, or even within institutions. 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The program's main weaknesses were the successive organizational changes and discontinuation of certain transition activities, and the potential conflict between the transition program and participation in research protocols. Further opportunities include the implementation of a multi-site transition model with cross-site personnel and user evaluations, with the inclusion of second-generation patients. Dissatisfaction reported by some care-team members at the adult care hospital could threaten collaboration among institutions involved in the transition process, whereas dissatisfaction of some former patients may reduce their perceptions of quality of care received during the transition. This study confirmed that a "one-size-fits-all" transition model for patients with OI would be inappropriate across, or even within institutions. Opportunities should be seized to create tailored, theoretically-sound transition programs that reflect patient preferences, especially those of young adults with complex and chronic health conditions. Alignment with other organizational activities should be considered, and ongoing evaluation of transition programming may be required. This SWOT analysis and utilization-focused evaluation has led to a comprehensive new project to improve the transition program for patients with OI and other conditions requiring special follow-up.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25366588</pmid><doi>10.1186/s12913-014-0489-1</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
Age
Child
Children
Committees
Data Collection - methods
Evidence-based medicine
Evidence-based nursing
Female
Genetic counseling
Health aspects
Health care policy
Hospitals
Humans
Life expectancy
Male
Medical care
Osteogenesis Imperfecta - therapy
Patients
Pediatrics
Preventive medicine
Program Evaluation
Quality management
Quebec
Teenagers
Transition to Adult Care
Young Adult
Young adults
title From pediatric to adult care: strategic evaluation of a transition program for patients with osteogenesis imperfecta
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