Quality Indicators for Transition from Pediatric to Adult Care for Youth With Chronic Conditions: Proposal for an Online Modified Delphi Study

被引：3

作者：

Toulany, Alene ^{[1
,2
,3
]}

Khodyakov, Dmitry ^{[4
]}

Mooney, Sarah ^{[5
,6
]}

Stromquist, Lisa ^{[7
]}

Bailey, Katherine ^{[1
,3
]}

Barber, Claire E. H. ^{[8
]}

Batthish, Michelle ^{[9
]}

Cleverley, Kristin ^{[1
,10
,11
]}

Dimitropoulos, Gina ^{[8
]}

Gorter, Jan Willem ^{[12
,13
]}

Grahovac, Danijela ^{[13
,14
]}

Grimes, Ruth ^{[15
]}

Guttman, Beverly ^{[16
]}

Hebert, Michele L. ^{[17
]}

John, Tomisin ^{[18
]}

Lo, Lisha ^{[19
]}

Luong, Dorothy ^{[20
]}

MacGregor, Laura ^{[21
]}

Mukerji, Geetha ^{[22
]}

Pidduck, Jacklynn ^{[23
]}

Senthilnathan, Vjura ^{[18
]}

Shulman, Rayzel ^{[1
,24
]}

Trbovich, Patricia ^{[3
,25
]}

Munce, Sarah E. P. ^{[20
,26
,27
]}

机构：

[1] Univ Toronto, Temerty Fac Med, Toronto, ON, Canada

[2] Hosp Sick Children, Dept Adolescent Med, 170 Elizabeth St, Toronto, ON M5G 1E8, Canada

[3] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[4] RAND, Santa Monica, CA USA

[5] Alberta Hlth Serv, Stollery Childrens Hosp, Edmonton, AB, Canada

[6] Univ Calgary, Alberta Strategy Patient Oriented Res Support Unit, Calgary, AB, Canada

[7] Childrens Healthcare Canada, Ottawa, ON, Canada

[8] Univ Calgary, Dept Med, Calgary, AB, Canada

[9] McMaster Univ, Dept Pediat, Hamilton, ON, Canada

[10] Ctr Addict & Mental Hlth, Toronto, ON, Canada

[11] Univ Toronto, Lawrence Bloomberg Fac Nursing, Toronto, ON, Canada

[12] Wilhelmina Childrens Hosp, Dept Rehabil Phys Therapy Sci & Sports, Utrecht, Netherlands

[13] McMaster Univ, CanChild Ctr Childhood Disabil Res, Hamilton, ON, Canada

[14] Childrens Healthcare Canada, Natl Hlth Hub Transit, Hamilton, ON, Canada

[15] Canadian Pediat Soc, Winnipeg, MB, Canada

[16] Prov Council Maternal & Child Hlth, Toronto, ON, Canada

[17] Univ Alberta, Fac Rehabil Med, Dept Occupat Therapy, Edmonton, AB, Canada

[18] Hosp Sick Children, Div Adolescent Med, Toronto, ON, Canada

[19] Univ Toronto, Ctr Qual Improvement & Patient Safety, Toronto, ON, Canada

[20] Univ Toronto, Rehabil Sci Inst, Toronto, ON, Canada

[21] Martin Luther Univ Coll, Waterloo, ON, Canada

[22] Womens Coll Hosp, Womens Inst Hlth Syst Solut & Virtual Care, Toronto, ON, Canada

[23] IWK Hlth, Halifax, NS, Canada

[24] Univ Toronto, Dept Paediat, Div Endocrinol, Toronto, ON, Canada

[25] North York Gen Hosp, Patient Safety & Qual Improvement, Toronto, ON, Canada

[26] Univ Hlth Network, Toronto Rehabil Inst, KITE, Toronto, ON, Canada

[27] Univ Toronto, Dept Occupat Sci & Occupat Therapy, Toronto, ON, Canada

来源：

JMIR RESEARCH PROTOCOLS | 2024年 / 13卷

关键词：

transition to adult care; adolescent health; chronic conditions; quality indicators; consensus; caregivers; adolescent; stakeholderengagement; patient engagement; Delphi; HEALTH-CARE; EXPERIENCES; ADOLESCENTS; IMPROVEMENT; PATIENT; MODELS;

D O I：

10.2196/60860

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background:The transition from pediatric to adult care poses a significant health system-level challenge impeding the delivery of quality health services for youth with chronic health conditions. In Canada and globally, the transition to adult care is regarded as a top priority in adolescent health in need of readily applicable, adaptable, and relevant national metrics to evaluate and benchmark transition success across disease populations and clinical care settings. Unfortunately, existing literature fails to account for the lack of engagement from youth and caregivers in developing indicators, and its applicability across chronic conditions, primary care involvement, and health equity considerations. Objective:Our proposed study aims to establish a consensus-driven set of quality indicators for the transition to adult care that are universally applicable across physical, developmental, and mental health conditions, clinical care settings, and health jurisdictions. Methods:Using an integrated knowledge translation (iKT) approach, a panel comprising youth, caregivers, interdisciplinary health care providers, and health system leaders will be established to collaborate with our research team to ensure that the study methodology, materials, and knowledge dissemination are suitable and reflect the perspectives of youth and their families. We will then conduct an iterative 3-round Online Modified Delphi (OMD) study (n=160) to (1) compare and contrast the perspectives of youth, caregivers, health care providers, and health system leaders on quality indicators for transition; and (2) prioritize a key set of quality indicators for transition applicable across disease populations that are the most important, useful, and feasible in the Canadian context. Using the RAND/UCLA Appropriateness Method (RAM) multistage analytic approach, data from each panel and stakeholder group will be examined separately and compared to establish a key set of indicators endorsed by both panels. Results:The study is funded by the Canadian Institutes of Health Research and Physicians Services Incorporated. Conclusions:This study will produce quality indicators to evaluate and inform action equitably to improve transition from pediatric to adult care for youth and their families in Canada.

引用

页数：10

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[1] Rising Healthcare Costs and Utilization among Young Adults with Cirrhosis in Ontario: A Population-Based Study [J].