title: Quantitative evaluation of a pediatric rheumatology transition program.
abstract: BACKGROUND
  Transition from pediatric to adult care can be a challenging process which leaves young people vulnerable to interruptions of care and worsening disease status. Efforts to improve transition processes and outcomes have included development of individualized transition plans, creation of transition clinics, and utilization of transition coordinators. Few interventions have assessed transition outcomes quantitatively.
  
  
  METHODS
  We assessed transition outcome and satisfaction of a social worker-centered transition program in a pediatric rheumatology clinic. The social worker met with patients who were 16 years or older and their families, provided transition education materials, assisted patients in developing an individualized transition plan, assisted in making appointments with an adult rheumatologist at time of transfer of care, and followed up with patients to assess transition outcomes. Patients were contacted 6-8 months after initial appointment with the adult rheumatologist to assess whether they remained in the care of the adult provider. Participants then completed a questionnaire to rate their satisfaction with the transition program.
  
  
  RESULTS
  210 adolescents and young adults participated in the transition program. Twenty-six similarly aged patients were eligible for transition services but did not participate in the program and were used as controls. Of the patients who participated in the program, 42% were considered to have transitioned successfully to adult care compared to 23% of controls (p-value = 0.002) of all patients. In the survey of satisfaction, 81% of participants said that they were satisfied with the transition process.
  
  
  CONCLUSIONS
  This study shows that a social worker transition coordinator can significantly improve the rate of pediatric rheumatology patients who successfully transition to adult care. Furthermore, patients are largely satisfied with this process.
authors.affiliation: Department of Internal Medicine, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue Third Floor, Columbus, OH, 43210, USA. Paul.Jensen@osumc.edu.|Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Paul.Jensen@osumc.edu.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Jensen
authors.affiliation: Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Jill.Karnes@nationwidechildrens.org.
authors.forename: Jill
authors.initials: J
authors.lastname: Karnes
authors.affiliation: Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Karla.Jones@nationwidechildrens.org.
authors.forename: Karla
authors.initials: K
authors.lastname: Jones
authors.affiliation: Center for Biostatistics, The Ohio State University Wexner Medical Center, 2012 Kenny Road, Columbus, OH, 43221, USA. Amy.Lehman@osumc.edu.
authors.forename: Amy
authors.initials: A
authors.lastname: Lehman
authors.affiliation: Department of Pediatrics, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. Rennebr@ccf.org.
authors.forename: Robert
authors.initials: R
authors.lastname: Rennebohm
authors.affiliation: Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Gloria.Higgins@nationwidechildrens.org.
authors.forename: Gloria C
authors.initials: GC
authors.lastname: Higgins
authors.affiliation: Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Charles.Spencer@nationwidechildrens.org.
authors.forename: Charles H
authors.initials: CH
authors.lastname: Spencer
authors.affiliation: Department of Internal Medicine, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue Third Floor, Columbus, OH, 43210, USA. Stacy.Ardoin@osumc.edu.|Department of Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. Stacy.Ardoin@osumc.edu.
authors.forename: Stacy P
authors.initials: SP
authors.lastname: Ardoin
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D017060:Patient Satisfaction; D010372:Pediatrics / Q000379:methods*; D012216:Rheumatic Diseases / Q000628:therapy*; D012219:Rheumatology / Q000379:methods*; D012947:Social Work / Q000379:methods; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care / Q000706:statistics & numerical data*; D055815:Young Adult