SMART Transitions: A Program Evaluation

Introduction: Various programs have been proposed to facilitate more successful transitions from pediatric to adult care for children with special health care needs. Few have been evaluated for their effectiveness. The purpose of this project was to systematically evaluate the Duke Complex Care Clinic using the social-ecological model of adolescent and young adult readiness for transition (SMART). Methods: Cross-sectional data were acquired from surveys of 23 patient/parent dyads and from retrospective chart reviews for 50 patients. After the initial program evaluation, a pilot transition readiness tracking tool was implemented. Results: Documentation of compliance with the SMART domains was high. Despite high satisfaction with the clinic and a focus on transition, many of the patient/parent dyads expressed low confidence in their ability to transition successfully. Conclusions: Transition beliefs and expectations should be further assessed and addressed in transition care visits. Further modification of the patient tracking tool and clinic flow may improve patient transition outcomes.