Adult practices in the transition program partner with pediatric practices to provide necessary medical care and support needed for youth with special healthcare needs during the transition from pediatric care to adult care. The adult provider’s transition team works closely with the pediatric transition team to ensure that all essential medical and social aspects of the transitioning young adult are effectively communicated to the new provider of care.
This process is accomplished through discussion between the pediatric and adult providers and review of relevant medical information and care plans prior to the patient’s initial meeting with the adult provider of care. The adult provider then meets with the new patient to explain the young adult model of care, assess the needs of the patient, and clarify the adult provider’s role in the care of the patient. As the young adult patient is integrated into the adult model of care, the new provider maintains communication with the pediatric practice for any necessary consultation.
As the administrator of the PA Medical Home Initiative and Transition program, PA AAP identifies adult practices that are willing and able to care for young adults with special healthcare needs and introduces them to the established system of transition. PA AAP then coordinates a partnership with nearby participating pediatric practices. The PA AAP team also helps enable the transition process by encouraging regular communication between the adult and pediatric practices and providing regular in person education, tools to facilitate the transition, and community resources for the practices and their families.