Details

Autor(en) / Beteiligte

• Wiemann, Constance M
• Needham, Heather E
• Jones, Demonica L
• Hergenroeder, Albert C

Titel

EVALUATION OF AN EDUCATIONAL INTERVENTION AMONG PEDIATRIC AND MEDICINE-PEDIATRIC RESIDENTS TO PROMOTE HEALTHCARE TRANSITION PLANNING

Ist Teil von

• Journal of adolescent health, 2020-02, Vol.66 (2S), p.S47

Ort / Verlag

New York: Elsevier BV

Erscheinungsjahr

2020

Quelle

Applied Social Sciences Index & Abstracts (ASSIA)

Beschreibungen/Notizen

• Purpose: Most pediatric providers are ill-equipped to help patients learn the skills needed to effectively manage their adult healthcare. In order to initiate a successful transition from pediatric to adult care, medical providers need knowledge and skills in this area which starts with introducing transition care to medical residents during residency. An electronic medical record-based Transition Planning Tool (TPT) was developed to guide provider-patient interactions and provide resources addressing patient deficits in knowledge/skills regarding healthcare self-management. We evaluated an intervention to promote TPT use by pediatric and medicine-pediatric residents on a one-month adolescent medicine rotation at a large children's hospital. The goal of this research study was to develop and evaluate an educational intervention to promote use of a TPT among pediatric and medicine-pediatric residents. Methods: A prospective, non-randomized, quasi-experimental design with intervention and historical control groups was used. Forty two residents received the educational intervention (TPT demonstration and modeling, case-conference incorporating transition planning, and TPT use reminders) during their rotation (July 2018-April 2019). Twenty-three historical control residents received informal training in healthcare transition (HCT) planning during their rotation (January-May 2018) and were introduced to the TPT but were not formally instructed to use it. Residents receiving the intervention completed pre-and post-rotation assessments measuring perceived importance of and comfort with transition planning and self-reported transition planning activities. TPT use in the form of Epic-generated electronic reports was compared between residents in the intervention and historical control groups using t-tests. Results: Among intervention participants, the perceived importance of HCT planning increased over the rotation, with 71% and 85% at prevs post-rotation, respectively, rating it as "very important" (p=0.11). Residents reported being significantly (p=0.001) more likely to engage in shared HCT planning activities (e.g., offer the patient the opportunity to be interviewed without parents or guardians present, ensure patient is knowledgeable about their diagnosis and current treatments) with their patients after being trained to use the TPT than before the rotation started. Nearly all (91%) reported that the training they received increased their comfort in helping youth with special health care needs manage their healthcare transition. Compared to the historical control group, residents who completed the intervention were significantly more likely to use the TPT (99% vs. 37%, p<0.001) and had a higher mean number of uses over the onemonth period (5.5 3.0 vs. 2.6 1.2, p<0.001). Conclusions: Pediatric residents' ratings of the importance of HCT preparation and their skills in facilitating HCT planning using an EMR-based TPT were improved with a targeted intervention program. Future steps include ongoing monitoring of TPT use in the Adolescent Medicine resident rotation and their use of the TPT on other rotations. In addition, strategies will be explored to implement booster training sessions in residency year 3.