Pediatric Transition Portal
Learn how to support adolescents and young adults during transfer from the pediatric setting to adult care.
The Need for a Transition Plan
Transplantation has become a successful treatment for end-stage organ disease due to medical and surgical innovations as well as improvements in health care.
Pediatric recipients are becoming long term survivors, with an improved quality of life and excellent outcomes. Although this is always the goal, there are many challenges along the way, particularly during adolescence.
Adolescents and young adults (AYAs) are most vulnerable during transfer from the pediatric setting to adult care. The AYA who received a transplant at a very young age may not have a good understanding of their chronic condition and may also be more dependent upon the adults in their lives for their care.
In addition, adult providers may not have the experience and depth of understanding about pediatric issues that follow the AYA as they transfer to adult care.
The goal of transition is to prepare the AYA and parents/guardians for a successful transfer to adult care through a comprehensive patient-centered and developmentally appropriate transition program.
Completing a transition program should enable the AYA to achieve self-efficacy and optimize their independence to provide self-care to the best of their ability.
How to Use the Tools
The Pediatric Community of Practice of the AST has developed several transition tool templates to assist providers in preparing adolescents and young adults (AYAs) and their parents or guardians for this critical transition to adult care.
Each tool is designed as a basic template that can be adapted to the individual transplant center based on their patient population and resources.
The templates are grouped by age from Early to Late Adolescence.
Readiness Assessment Tool
The Readiness Assessment Tool is designed as a qualitative interview format between the AYA and pediatric provider to assess the AYA’s strengths and weaknesses in their knowledge about transplant and in achieving self-efficacy. It can be administered as the entire tool, or by sections based on the goals of the team. The provider’s assessment will then guide educational interventions to help the AYA reach their goals for transition, which can be documented using the Transition Action Plan.
Readiness Checklist
The Readiness Checklist is for providers who prefer a "quick" assessment that is self-administered by the AYA using a short form checklist, rather than a qualitative assessment. This form can easily be used during clinic appointments. The provider’s assessment of the AYA’s comments will be used to guide educational interventions that can be documented through the Transition Action Plan.
Transition Action Plan
The Action Plan can be used to set individual goals for each domain and to guide educational interventions and counseling to help the AYA achieve self-efficacy.
Parent Action Form
This form parallels the Transition Action Plan and will guide the parent/guardian in helping their adolescent achieve independence and improve self-efficacy.
Tools by Stage
Transition Resources
Visit our Resources on Transition to Adult Care for literature searches, articles, programs, and more.
This resource is made possible with generous support by:
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