Health Care Transitions最新文献

{"title":"Training young adults as community health workers specializing in pediatric to adult health care transition to support emerging adults with sickle cell disease","authors":"Tanisha D. Belton ,&nbsp;Katherine Wu ,&nbsp;Caren M. Steinway ,&nbsp;Symme W. Trachtenberg ,&nbsp;Trudy Tchume-Johnson ,&nbsp;Steffi Shilly ,&nbsp;Tahirah Austin ,&nbsp;Samantha Luma ,&nbsp;Kyle Smith ,&nbsp;Kim Smith-Whitley ,&nbsp;David Rubin ,&nbsp;Sophia Jan","doi":"10.1016/j.hctj.2024.100050","DOIUrl":"https://doi.org/10.1016/j.hctj.2024.100050","url":null,"abstract":"<div><h3>Background</h3><p>Transition to adulthood is a vulnerable time for emerging adults (16–25 years of age) with sickle cell disease (SCD), as there is a seven-fold increase in mortality rates during the transition period. Emerging adults with SCD also have the highest rates of hospitalizations, emergency room visits, and hospital readmissions compared to other age groups. Community health worker (CHW) programs have been developed to address outcomes such as patient activation which includes an individual’s knowledge, skill, and confidence for managing one’s health and healthcare, quality of life, and healthcare utilization for patients with chronic illnesses. However, few programs specifically target transition-age patients with SCD.</p></div><div><h3>Methods</h3><p>The aims of this study were to (1) create and adapt the existing Penn Center for Community Health Workers IMPaCT model trainings and materials to specifically support CHWs working with transition-age patients with SCD and (2) evaluate the feasibility of this adapted model to improve job readiness of the CHWs and perceived value of the CHWs by patients with SCD. A multidisciplinary workgroup defined specific goal-setting categories and developed a targeted CHW training curriculum. Additionally, the workgroup wrote a job manual including step-by-step guidelines with example talking points and defined an ongoing supervision of CHWs. Measures of implementation and impact on CHW job readiness included CHW training completion, job retention, knowledge evaluation, and patient reported CHW engagement.</p></div><div><h3>Results</h3><p>15 individuals completed CHW training with an average employment length of 1 year and 4 months. 7 (47%) CHWs had research experience, 8 (53%) had clinical experience, and 11 (73%) reported SCD experience. On post-training knowledge evaluations, CHWs successfully identified key aspects of SCD, role scope, and research ethics. Patients frequently reported that they reached their goals while working with trained CHWs.</p></div><div><h3>Conclusion</h3><p>This CHW training program provides a novel adaptation to the evidence-based IMPaCT CHW model to support the needs of youth with SCD during the vulnerable time of transition from pediatric-focused to adulthood-focused healthcare.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100050"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000102/pdfft?md5=657033b65f5d185f5efecd32f7afca16&pid=1-s2.0-S2949923224000102-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139908101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care transition experiences of young adults with medical complexity","authors":"Rhonda G. Cady ,&nbsp;Tori Bahr ,&nbsp;Carrie Au-Yeung ,&nbsp;Sera Kinoglu ,&nbsp;Megan Lutz ,&nbsp;Mark Jankowski","doi":"10.1016/j.hctj.2024.100070","DOIUrl":"10.1016/j.hctj.2024.100070","url":null,"abstract":"<div><h3>Background</h3><p>Transition from pediatric to adult healthcare and services is an important event in the life course of all youth, including youth living with medical complexity. Data from the National Survey of Children’s Health indicates less than 20 % of youth receive health care transition services. The goal of our study was understanding the support, tools and resources that facilitate successful health care transition of young adults living with medical complexity.</p></div><div><h3>Methods</h3><p>Young adults living with medical complexity and their parents shared their lived experience of ‘what worked’ and ‘what is needed’ for successful health care transition during focus group sessions. Content analysis of transcripts used an iterative and deductive approach guided by a priori themes.</p></div><div><h3>Findings</h3><p>The voices of ten young adults and fourteen parents were shared during three virtual focus group sessions. They described health care transition (HCT) as an individualized process with success relying on consistent, clearly-defined and systemwide guidelines and resources. Moving from pediatric/family-focused care to adult/patient-focused care requires increased self-management and young adults often felt under-prepared for this role. Support from formal transition coordinators would improve communication between the multiple health, county/state agency and education systems involved during the transition period.</p></div><div><h3>Conclusions</h3><p>Understanding the support, tools, and resources specifically needed by young adults with medical complexity for successful pediatric to adult health care transition is a critical first step in addressing the documented lack of transition services for this vulnerable population. This includes formal peer support programs for young adults with medical complexity and their parents.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000308/pdfft?md5=80476fcfd536a59520ef8c2ac7e06719&pid=1-s2.0-S2949923224000308-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142150001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial outcomes in a sickle cell disease transition clinic","authors":"Katheryne Madrazo-Aguirre ,&nbsp;Jean-Antoine Ribeil ,&nbsp;Amy E. Sobota","doi":"10.1016/j.hctj.2024.100056","DOIUrl":"https://doi.org/10.1016/j.hctj.2024.100056","url":null,"abstract":"<div><h3>Background</h3><p>Transition in sickle cell disease (SCD) is associated with an alarming increase in acute care utilization, cost, and risk of early mortality. Effective transition preparation is crucial to address these issues. We established a multidisciplinary transition clinic at our urban SCD center in the fall of 2021. At each visit patients were introduced to the transition process and met with a pediatric and adult SCD provider.</p></div><div><h3>Methods</h3><p>We reviewed charts of patients attending the clinic from September 2021 to May 2023. Data were collected on the number of visits in the transition and adult SCD clinics. Clinic notes were reviewed, identifying the main topics of discussion, and examining patient attitudes and feelings towards transition.</p></div><div><h3>Results</h3><p>Twenty-two patients aged 20–27 years with 35 total visits were included in the analysis. Eighteen (82%) patients had at least 1 visit to transition clinic. Out of 10 scheduled patients, 8 attended their first adult care visit within 2.4 months of their last transition visit. Medical topics brought up by patients included difficulty remembering to take hydroxyurea, questions about reproductive and menstrual health, and support pursing higher education with a chronic disease. Patients expressed a variety of feelings about transition from “no concerns” to “nervousness” and questioning “what to expect”. Concerns were alleviated by learning about the process. One patient reported feeling “much better\" after being introduced to the adult provider.</p></div><div><h3>Conclusion</h3><p>We demonstrated that a collaborative transition clinic prepares young adults with SCD for transition to adult care. Meeting with their adult SCD provider prior to transfer helped alleviate patients’ concerns. Future work will involve tracking patients as they integrate into adult clinic.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100056"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000163/pdfft?md5=65e780273027c9fb7cf3313536187098&pid=1-s2.0-S2949923224000163-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140138669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the transition of adolescents and young adults with palliative care needs from pediatric to adult care","authors":"Emma W. Healy ,&nbsp;Natasha Z. Piracha","doi":"10.1016/j.hctj.2024.100072","DOIUrl":"10.1016/j.hctj.2024.100072","url":null,"abstract":"<div><h3>Background</h3><p>The transition from pediatric to adult healthcare poses significant challenges for adolescents and young adults (AYA), especially those with chronic conditions, yet most children receive inadequate transition preparation. Research on the transition for patients receiving palliative care services is particularly limited. We sought to address this gap in the literature.</p></div><div><h3>Methods</h3><p>Young adults aged 18 to 35 years who transitioned from the pediatric setting and received adult palliative care services at an urban academic medical center between the dates of February 1st_, 2020 and July 1st, 2022 were identified retrospectively via electronic medical record. Chart review was used to investigate outcomes of interest, including use of pediatric palliative care services and timing of care conversations.</p></div><div><h3>Results</h3><p>Only 23 % of patients interfaced with pediatric palliative care, despite all having childhood diagnoses. Pediatric palliative care exposure was associated with a significantly earlier median age of first adult palliative care encounter (19.63 versus 25.06, p = &lt;0.001). Goals of care discussions, code status conversations, and healthcare proxy documentation occurred earlier if pediatric palliative care was involved (18.9 years versus 25.7 years, p &lt; 0.001; 20.9 years versus 30.0 years, p &lt; 0.001; 20.7 versus 28.9, p &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Pediatric palliative care services were underutilized in AYA patients, but when used, were associated with earlier adult palliative care encounters, goals of care discussions, code status decisions, and health care proxy identification.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100072"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000321/pdfft?md5=3220ceff60f54c5dbfb393cdaefa750a&pid=1-s2.0-S2949923224000321-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition services in mental health — A suitable solution for young patients? A qualitative study of the opinions of adolescent and adult psychiatrists in Portugal","authors":"José António da Costa Salgado","doi":"10.1016/j.hctj.2024.100076","DOIUrl":"10.1016/j.hctj.2024.100076","url":null,"abstract":"<div><h3>Objectives</h3><div>Transition from pediatric to adult health services is a difficult and common problem in many medical specialties, particularly in mental health, fraught with pitfalls that threaten its success and disrupt the continuity of care. However, there is a lack of research on this topic. The aim of this study was to characterize the perceptions of Portuguese physicians who are responsible for direct intervention in this process—child and adolescent psychiatrists (CAP) and adult psychiatrists (AP)—and to explore the possibilities for improvement.</div></div><div><h3>Methods</h3><div>A qualitative methodology was adopted, using thematic analysis to evaluate results, participants were selected using a convenience sampling of CAPs and APs in Lisbon area, 28 APs and 18 CAPs expressed interest in participating.</div><div>Saturation point was reached after interviewing eight CAPs and 13 APs, and the interviews were first listened to and transcribed, then NVivo software was used to facilitate coding of data.</div></div><div><h3>Results</h3><div>Many young people transition informally to adult services. Relying on the commitment of doctors, families, and patients is common in clinical discharge to general practitioners, who then make psychiatric referrals. A formal and standardized transition process was not found. Two-thirds of the respondents thought that transition services were useful, while others thought that such services were not needed and had no positive effect on the quality of care. However, all agreed that in the absence of transition protocols, informal transfers provided the best results.</div></div><div><h3>Conclusions</h3><div>All participants agreed on the importance of a seamless transition to ensure the continuity of care and that developing transition strategies to improve communication between pediatric and adult services would be beneficial. Some participants considered this issue for the first time. This suggests that the situation in Portugal is similar to that in other countries, highlighting a lack of awareness of the importance of transition process for patient outcomes.</div></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent transition preparation around the COVID-19 pandemic: A cross-sectional study","authors":"Sarah P. Cohen ,&nbsp;Andrew H. Tran ,&nbsp;Robin Alexander ,&nbsp;Laura C. Hart","doi":"10.1016/j.hctj.2024.100066","DOIUrl":"10.1016/j.hctj.2024.100066","url":null,"abstract":"<div><h3>Objective</h3><p>To compare preparation for transition in adolescents in the United States prior to and during the COVID-19 pandemic.</p></div><div><h3>Study Design</h3><p>We used data from the 2019 and 2021 National Survey of Children’s Health to compare transition preparation before and after the COVID-19 pandemic among adolescents who had a medical care visit within the preceding year, controlled for relevant potential confounders. The association of demographic factors and survey year with a composite measure of adequate transition preparation was evaluated using univariable analysis and multivariable logistic regression.</p></div><div><h3>Results</h3><p>The difference in transition preparation was not significant when comparing 2019 to 2021 (9.25 % in 2019 vs. 8.67 % in 2021, p = .556), despite changes in potential confounders, such as worse caregiver mental or emotional health and fewer adolescents having insurance or a usual source of preventive care. Older adolescents (odds ratio for each year 1.321, 95 % confidence interval 1.196 – 1.459), females (odds ratio 1.153, 95 % confidence interval 1.02 – 1.304) were more likely to have received adequate transition preparation. Adolescents from Spanish-speaking homes were less likely than adolescents from English-speaking homes to have received adequate transition preparation (odds ratio 0.529, 95 % confidence interval 0.329 – 0.849).</p></div><div><h3>Conclusions</h3><p>The proportion of adolescents in the United States who received adequate preparation to transition to adult care did not change during the COVID-19 pandemic. However, in both years studied, only a small minority of adolescents in the United States were adequately prepared.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000266/pdfft?md5=2194eaf2e649ac18bbe9cf87110bd368&pid=1-s2.0-S2949923224000266-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141963713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived barriers transitioning to adult healthcare among adults with spina bifida","authors":"Tessa K. Kritikos ,&nbsp;Colleen Stiles-Shields ,&nbsp;Raynie S. Leard ,&nbsp;Grayson N. Holmbeck","doi":"10.1016/j.hctj.2024.100054","DOIUrl":"https://doi.org/10.1016/j.hctj.2024.100054","url":null,"abstract":"<div><h3>Background</h3><p>This study examined perceived barriers to transitioning to adult healthcare among a sample of young adults with spina bifida (SB) and the degree to which these perceived barriers have impeded the transition process, and assessed relationships between these self-reported barriers and demographic and medical variables.</p></div><div><h3>Methods</h3><p>In a large national survey conducted in 2019, young adults with SB between the ages of 18 and 30 years old (<em>N</em> = 326) completed a questionnaire on perceived barriers to transition, which yielded scores representing the proportion of barriers experienced and the degree of interference of these barriers. Participants included both individuals who reported that they already transitioned to adult healthcare and those who did not.</p></div><div><h3>Results</h3><p>Participants endorsed a high number of barriers, with an average of 13 (<em>SD</em> = 7.39) of the 21 assessed barriers occurring for participants. Barriers were reported to be significantly interfering (<em>M</em> = 2.38, <em>SD</em> = 0.54, range: 1- 4). Higher proportions of barriers were experienced by individuals who returned to a pediatric provider after transitioning, males, employed or students, and with sacral lesion levels. Higher interference scores were reported by individuals who returned to a pediatric provider after transitioning, as well as by individuals who identified as White, and who had a shunt.</p></div><div><h3>Conclusion</h3><p>Implications for transition programs and support are discussed.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100054"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294992322400014X/pdfft?md5=3f017c9b103045940c58ce93981b9d57&pid=1-s2.0-S294992322400014X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140309212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing LGBTQ+ affirming care to young adults with inflammatory bowel diseases","authors":"Cade Johnson ,&nbsp;Sneha Dave ,&nbsp;Sydney Reed ,&nbsp;Victor Chedid ,&nbsp;Lucy Laube ,&nbsp;Laura Targownik","doi":"10.1016/j.hctj.2023.100030","DOIUrl":"https://doi.org/10.1016/j.hctj.2023.100030","url":null,"abstract":"<div><p>Creating an affirming care environment for young adults with IBD in the LGBTQ+ community is an essential part of inflammatory bowel disease (IBD) care. This article summarizes the discussions held during the Roundtable on Young Adults with IBD, which focused on essential information for adult-care providers to successfully navigate the complexities and intricacies of sexuality and gender identity for young adult IBD patients. The Roundtable on Young Adults with IBD is held through the Crohn’s and Colitis Young Adults Network. Key focus areas include establishing effective communication between providers and patients, maintaining patient safety and privacy, emphasizing trauma-informed practices, and building trust-based provider-patient relationships. Addressing these issues will allow providers to more fully and effectively treat LGBTQ+ young adults with IBD, ensuring a better, safer path into successful adult lives.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100030"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923223000302/pdfft?md5=4769e49e235ca97225e660c671e384f9&pid=1-s2.0-S2949923223000302-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138472057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care transition planning and outcomes: What’s next?","authors":"Cecily L. Betz PhD, RN, FAAN (Editor-in-Chief) ,&nbsp;Maria E. Díaz-González de Ferris MD, MPH, PhD (Associate Editor)","doi":"10.1016/j.hctj.2024.100045","DOIUrl":"10.1016/j.hctj.2024.100045","url":null,"abstract":"","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949923224000059/pdfft?md5=dc0baef14bdd133066590150e7dcddc6&pid=1-s2.0-S2949923224000059-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139827877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An institution-wide mixed methods assessment of healthcare transition","authors":"Anisha Maheshwari ,&nbsp;Anna Maria Coronata ,&nbsp;Laura Kirkpatrick ,&nbsp;Ahmed Abdul-Al ,&nbsp;Andrew McCormick ,&nbsp;Loreta Matheo ,&nbsp;Traci M. Kazmerski","doi":"10.1016/j.hctj.2023.100034","DOIUrl":"https://doi.org/10.1016/j.hctj.2023.100034","url":null,"abstract":"<div><h3>Background</h3><p>Healthcare transition (HCT) is the process of moving a patient from pediatric, parent-supervised care to an independent, adult-centered model. This study assesses current HCT activities and explores the educational and system-based needs for effective HCT processes in a single institution.</p></div><div><h3>Methods</h3><p>We interviewed division/care program leaders at one academic tertiary-care children’s hospital regarding HCT practices. We evaluated these groups using an interview guide and rubric scoring from the “GotTransition Current Assessment of HCT Activities” (scoring range from 8 [low HCT] to 32 [high HCT]). We audio-recorded and transcribed interviews. We calculated each group’s score on the rubric. Two coders qualitatively analyzed interview transcripts using a thematic analysis approach with deductive and inductive strategies.</p></div><div><h3>Results</h3><p>We interviewed 28 participants, each representing one division/care program. The institutional mean on the HCT assessment was 15.5 ± 4.5 (median 17.5, range 8–28). Key interview themes included: 1) Significant heterogeneity in the HCT process exists within most divisions/care programs; 2) While some groups have their own HCT practices, there is no coordinated institutional HCT approach.; 3) Participants find HCT difficult if they perceive the lack of an equivalent adult specialist for a patient’s specific medical condition; 4) There is a lack of coordinated handoffs from pediatric to adult providers. 5) Participants desire ancillary staff to support HCT.</p></div><div><h3>Conclusion</h3><p>Despite known benefits of a structured approach, most leaders report heterogeneity in current HCT practices and a lack of institutional resources and adult provider partners to support optimal HCT. We present a reproducible methodology to evaluate HCT within a single institution, as well as baseline assessment data that may inform interventions.</p></div>","PeriodicalId":100602,"journal":{"name":"Health Care Transitions","volume":"2 ","pages":"Article 100034"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294992322300034X/pdfft?md5=bb4a3f1761628f1edbcda4ecf7d59f10&pid=1-s2.0-S294992322300034X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138581990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}