title: Evaluating outpatient transition clinics: a mixed-methods study protocol.
abstract: To support young people in their transition to adulthood and transfer to adult care, a number of interventions have been developed. One particularly important intervention is the transition clinic (TC), where paediatric and adult providers collaborate. TCs are often advocated as best practices in transition care for young people with chronic conditions, but little is known about TC models and effects. The proposed study aims to gain insight into the added value of a TC compared with usual care (without a TC).
  
  
  
  We propose a mixed-methods study with a retrospective controlled design consisting of semistructured interviews among healthcare professionals, observations of consultations with young people, chart reviews of young people transferred 2-4 years prior to data collection and questionnaires among the young people included in the chart reviews. Qualitative data will be analysed through thematic analysis and results will provide insights into structures and daily routines of TCs, and experienced barriers and facilitators in transitional care. Quantitatively, within-group differences on clinical outcomes and healthcare use will be studied over the four measurement moments. Subsequently, comparisons will be made between intervention and control groups on all outcomes at all measurement moments. Primary outcomes are 'no-show after transfer' (process outcome) and 'experiences and satisfaction with the transfer' (patient-reported outcome). Secondary outcomes consider clinical outcomes, healthcare usage, self-management outcomes and perceived quality of care.
  
  
  
  The Medical Ethical Committee of the Erasmus Medical Centre approved the study protocol (MEC-2014-246).
  
  
  
  Study results will be disseminated through peer-reviewed journals and conferences. The study started in September 2014 and will continue until December 2016. The same study design will be used in a national study in 20 diabetes settings (2016-2018).
authors: Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
authors: Jane N T
authors: JN
authors: Sattoe
authors: Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors: Mariëlle A C
authors: MA
authors: Peeters
authors: Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
authors: Sander R
authors: SR
authors: Hilberink
authors: Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands.
authors: Erwin
authors: E
authors: Ista
authors: Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors: AnneLoes
authors: A
authors: van Staa
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000628:therapy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D059012:Lost to Follow-Up; D008297:Male; D009426:Netherlands; D010045:Outpatients; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D036301:Qualitative Research; D011788:Quality of Life; D012107:Research Design; D012189:Retrospective Studies; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires; D060305:Transition to Adult Care / Q000592:standards*
keywords: Self-management; Successful transfer