title: Integrating an EMR-based Transition Planning Tool for CYSHCN at a Children's Hospital: A Quality Improvement Project to Increase Provider Use and Satisfaction.
abstract: An electronic medical record (EMR)-based transition planning tool (TPT) designed to facilitate transition from pediatric to adult-based health care for youth (16-25 years) with special health care needs was introduced at a large children's hospital. Activities to increase provider use were implemented in five plan-do-study-act cycles. Overall, 22 of 25 (88%) consenting providers in four pediatric subspecialty services used the TPT during 303 patient encounters, with nurses and case-managers the top users and physicians the least likely users. Use was highest with intensive technical assistance and following the introduction of an upgraded tool. Provider satisfaction with the TPT and self-reported transition planning activities notably increased across the PDSA cycles.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX. Electronic address: cwiemann@bcm.edu.
authors.forename: Constance M
authors.initials: CM
authors.lastname: Wiemann
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Hergenroeder
authors.affiliation: Center for Clinical Effectiveness, Baylor College of Medicine, Houston, TX.
authors.forename: Krystle A
authors.initials: KA
authors.lastname: Bartley
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: Blanca
authors.initials: B
authors.lastname: Sanchez-Fournier
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: Marisa E
authors.initials: ME
authors.lastname: Hilliard
authors.affiliation: Texas Parent to Parent, Austin, TX.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Warren
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Graham
mesh_terms: D000293:Adolescent; D000328:Adult; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000458:organization & administration; D006801:Humans; D008297:Male; D010347:Patient Care Planning / Q000458:organization & administration; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D058996:Quality Improvement; D060305:Transition to Adult Care / Q000458:organization & administration*; D000069341:Transitional Care / Q000458:organization & administration; D014481:United States; D055815:Young Adult
keywords: CYSHCN; Electronic medical record; Health care transition planning; PDSA; Quality improvement