title: Walking the talk. Implementation of transitional care guidance in a UK paediatric and a neighbouring adult facility.
abstract: OBJECTIVE
  To examine the quality of transitional care in a paediatric and adult hospital by investigating (i) adherence to national transition guidance and (ii) whether implementation is associated with better patient/carer experiences.
  
  
  METHODS
  A cross-sectional study was conducted in a UK paediatric hospital (PH) and neighbouring adult hospital. Clinics completed a questionnaire to determine characteristics of their transitional care provision and invited patients aged 11-21 years and parents/carers to complete a questionnaire ('Mind the Gap') to assess their satisfaction.
  
  
  RESULTS
  Twenty-three clinics participated. Fourteen (70%) reported delivering a transition programme, but only 5 (25%) indicated this was holistic (addressing medical, psychosocial and vocational issues). Participants included 457 young people and 330 parents, 71% and 88% respectively attending the PH. Ratings of current care were significantly lower than ratings of best care. These 'gap' scores were not excessive, although some participants were very dissatisfied. Better satisfaction was associated with attending clinics that provided transitional care, especially when defined as 'holistic' and youth-friendly.
  
  
  CONCLUSIONS
  Transition programmes that adhere to current guidance are associated with better satisfaction, but variations in provision suggest barriers to implementation. Attention is required to how youth-friendly transitional care is defined with particular reference to the specific clinic model.
authors.affiliation: School of Health and Population Sciences (Nursing and Physiotherapy), University of Birmingham, Birmingham, UK.
authors.forename: K L
authors.initials: KL
authors.lastname: Shaw
authors.forename: A
authors.initials: A
authors.lastname: Watanabe
authors.forename: E
authors.initials: E
authors.lastname: Rankin
authors.forename: J E
authors.initials: JE
authors.lastname: McDonagh
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D002648:Child; D002908:Chronic Disease / Q000523:psychology / Q000534:rehabilitation*; D015331:Cohort Studies; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult
keywords: adolescent; adult health care; healthcare quality; long-term conditions; paediatric health care; parent satisfaction; patient satisfaction; transition