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Research & Innovation
It starts with a Q:
For the latest cutting-edge research, innovative collaborations and remarkable discoveries in child health, read stories from across all our areas of study in Q: Advances and Answers in Pediatric Health.
The ImPACT Program: transitioning adolescents and young adults from pediatric to adult healthcare
We support and advocate for all young people and their families during the transition process from pediatric to adult healthcare through:
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Inclusion: We partner with young people and their families to integrate their long-term healthcare goals into the transition plan.
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Education: We serve as coaches to patients and their families to provide health education and to enhance confidence in disease self-management.
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Collaboration: We foster communication between pediatric and adult care teams and patients and families to create an individualized, uninterrupted continuum of care.
- Transition is preparation for the change from a pediatric model of care (where parents make most of the decisions) to an adult model of care (where the patient takes responsibility for decision-making).
- Transfer is the process of identifying an adult provider, collecting and transferring all appropriate medical records to adult providers and communicating the unique needs of the patient to the adult provider. This process requires collaboration and communication among the patient, the patient’s family and the healthcare teams.
Transition discussions between the patient, parents or caregivers and primary and specialty care providers typically begin between the ages of 12 and 14. The transition from pediatric to adult healthcare should include the patient, the patient’s family and the healthcare team so everyone understands the expectations of the adult healthcare setting. Chronic conditions usually require more collaboration. Learn more about transitioning a child with a chronic illness.
- The timing and age of transition varies based on patient readiness and specialty clinic planning or adult care specialist availability. Some specialties have a general plan for the timing of transition based on the conditions they treat and others will have stricter guidelines.
- The Children’s Hospital Colorado policy encourages transition to adult care no later than a patient’s 22nd birthday. However, there are some circumstances in which we may recommend continuing care with us as an adult. In these rare situations, we would provide an adult model of care instead of suggesting they transfer to an adult healthcare facility if we believe it's in the patient's best interest.
- Talk to your child’s specialists about their policies and procedures related to transition to adult healthcare, and make sure that your child’s primary care provider is also included in the conversation.
How can parents prepare their child as they transition to adult healthcare?
Parents should begin teaching and including their child in the self-management of their child’s general health and specific medical condition as they get older. Below are some general age guidelines and checklists you can use to help you and your child prepare for the transition process.
- Age 11 and under: Parents should model self-care in health activities and use simple pictures to explain health concepts and practice problem solving for both routine health and specific health conditions. Use this checklist to help you prepare.
- Age 14 to 17: Parents, providers and teens should begin discussing readiness for transition and encourage increased independence in activities related to their health. Use this checklist to help you prepare.
Many young adult patients still may choose to continue to involve their families in their healthcare decisions, but the team will encourage patients to become more involved in their own medical decisions and health management in preparation for taking primary responsibility for their healthcare.
The process depends on the child’s developmental ability to take on their own healthcare management. Learn tips for families with teens with developmental disability.
During visits, older youth and adolescent patients will learn more about their medical conditions, their medications and the tasks associated with taking care of their health, such as scheduling regular clinic visits and ordering prescription refills.
Teenagers are best prepared to take on the primary management of their illness when they are encouraged to ask questions and take on an active role.
Parents and providers will need to offer support, coaching and answer questions as needed. Ways to support children include:
- Encourage teens to play a role in scheduling their own medical visits, checking in when they arrive and spending time with their provider without a parent/caregiver present.
- Spend time with teens discussing the division of responsibility for healthcare tasks.
- Gradually increase expectations for adolescents’ responsibility in their healthcare while continuing to supervise these tasks.
Check out these helpful PDFs:
How is adult healthcare different than pediatric healthcare?
- Young adults must schedule their own appointments.
- Adult healthcare providers will support and manage care, but young adults are primarily responsible.
- Young adults are responsible for their own finances and payment.
- Young adults need to know about their healthcare coverage.
- Young adults must request their own treatment information.
While most young adults say they are ready for these differences, many will need additional support during transition. We recommend that young adults reach out for help from their friends, family and psychosocial providers if they are struggling with the transition process.
Are you ready to transition? Take the “Got Transition” Youth and Young Adult Healthcare Transition Quiz.
Check out these helpful PDFs:
When patients turn 18, they take charge of making their own healthcare decisions, and they become — legally — the only person who can access their medical information, unless other plans are made or permissions are documented in the medical record. This includes access to MyChart and other healthcare platforms where patients can communicate directly with providers, check labs and schedule appointments. Young adults ages 18 and older become the sole decision-makers about their healthcare and the sharing of personal health information. Only with the young adult’s written permission can healthcare providers discuss any personal health information with family members.
There is a range of options for assistance in decision-making after age 18 (the least restrictive is a signed consent form at the hospital, and the most restrictive option is legal guardianship). If young adults need support in making healthcare decisions, disability groups in each state can help guide you to legal resources.
Guardianship resources
Transition can come with additional stress and challenges for some teens and families. Consider reaching out to your medical team to obtain additional support, particularly the psychosocial providers on the team.
If teens are having significant difficulty with aspects of the transition process (such as adherence, emotional health or coping with a diagnosis), it may be helpful to consider getting additional support from specialists. These can include pediatric psychologists, social workers or other behavioral health providers who can provide additional support to teens and help them develop strategies to cope with challenges related to transition.
National resources
Health insurance resources
Contact
For further information regarding transition care, please contact your child's Children’s Hospital Colorado healthcare provider.