Transition is the process of transferring from child health care services to adult services and care teams.
There are many differences between the services provided at a children’s hospital (paediatric services) and adult services. A key difference is that child health services are family focused with parents or carers taking responsibility for care, whereas adult services require young adults to operate independently and be actively engaged in the management of their care.
Young people with childhood heart disease will transition into the adult health care system over a period of time. It is a gradual process involving preparation and planning. The actual transfer of care from a paediatric to adult cardiologist occurs at the age of 18 years.
Transition requires a unique set of skills, information and support. Transition programs are available to prepare and empower young people to manage their own health and facilitate a smooth transfer from paediatric to adult health services.
The four phases for an effective transition are:
Introductory planning phase (12-15 years old)
Patients are introduced to the concept of transition, starting the information exchange, and assessing their knowledge of their medical condition and how to manage it.
Preparation phase (15-18 years old)
Patients develop a transition plan and are assigned a transition lead (person who will help to manage the transition process). During this phase, confidentiality, rights and self-advocacy are explored.
Transfer phase (18-19 years old)
Readiness to transfer is assessed and all relevant information is sent to the new adult care team. The patient has their last visit with their paediatric cardiologist and will meet and start having appointments with their adult cardiologist.
Evaluation phase (6-18 months following transfer)
The patient and their parents and carers have the opportunity to provide feedback about the transition process and their experience.