{"id":456,"date":"2020-03-02T14:29:47","date_gmt":"2020-03-02T19:29:47","guid":{"rendered":"https:\/\/www.hydroassoc.org\/?p=456"},"modified":"2024-10-29T13:10:15","modified_gmt":"2024-10-29T17:10:15","slug":"transition-initiative","status":"publish","type":"post","link":"https:\/\/www.hydroassoc.org\/transition-initiative\/","title":{"rendered":"Transition Initiative: Transitioning from Pediatric to Adult Care"},"content":{"rendered":"<h4>HA&#8217;s Transition Initiative: Transitioning from Pediatric to Adult Care<\/h4>\n<p>With advances in diagnosis and treatment since the 1950s, the majority of individuals with hydrocephalus are living full and active lives. A major milestone for in a young adult living with hydrocephalus is the transition from pediatric to adult medical care. Each year in the US, an estimated 5000\u20136000 adolescents and young adults with hydrocephalus must move to the adult health care system, a process known as health care transition. This transition comes with significant challenges, ranging from negotiating the different processes and culture of adult care to the most significant being the ability for teens and young adults in our community to finding a neurosurgeon willing to take on their ongoing health care needs. That\u2019s why in 2017, the Hydrocephalus Association held the first-ever Transition Summit.<\/p>\n<p>The event brought together adult and pediatric neurosurgeons, neurologists, pediatricians, and other medical professionals, health system administrators, patients, and parents to discuss solutions to improve transitional and longitudinal care for adolescents and young adults with hydrocephalus. The Transition Summit produced a set of consensus recommendations for improving transition and longitudinal care. These recommendations are detailed below in our Transition Initiative Action Plan, which the association will undertake over the coming months and years, to ensure that our young adult patient population receives the longitudinal care they need to lead healthy and supported lives.<\/p>\n<p>The conclusions of the Summit are summarized in Williams MA, van der Willigen T, White P, Wood D, Cartwright C, \u201c<a href=\"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/aop\/article-10.3171-2018.6.JNS188.xml\" target=\"_blank\" rel=\"noopener noreferrer\">Improving Health Care Transition and Longitudinal Care for Adolescents and Young Adults with Hydrocephalus: Report from the Hydrocephalus Association Transition Summit<\/a>,\u201d which was published in the prestigious Journal of Neurosurgery. This paper also goes into more detail regarding recommendations relevant to neurosurgeons and neurologists and their professional societies.<\/p>\n<p>Read our blog to learn more about the Transition Summit: <a href=\"\/hydrocephalus-associations-transition-summit\/\">Tackling Obstacles to Finding Care for Young Adults with Hydrocephalus: Summary of the 2017 Transition Summit<\/a><\/p>\n<table class=\" alignleft\" style=\"height: 230px; width: 100%; border-collapse: collapse; border-style: solid; border-color: #e8e8e8;\" cellspacing=\"10px\" cellpadding=\"10px\">\n<thead>\n<tr style=\"background-color: #666666; height: 30px; border-color: #e0e0e0; border-style: solid;\">\n<td style=\"width: 15.0244%; height: 23px;\">\n<h4><span style=\"color: #ffffff; font-size: 10pt;\">\u00a0Primary Responsibility Area<\/span><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 23px;\">\n<h4><span style=\"color: #ffffff; font-size: 10pt;\">\u00a0Hospitals, Health Systems, and Practices<\/span><\/h4>\n<\/td>\n<td style=\"width: 31.4807%; height: 23px;\">\n<h4><span style=\"color: #ffffff; font-size: 10pt;\">\u00a0Professional Societies *<\/span><\/h4>\n<\/td>\n<td style=\"width: 23.2363%; height: 23px;\">\n<h4><span style=\"color: #ffffff; font-size: 10pt;\">\u00a0Hydrocephalus Association<\/span><\/h4>\n<\/td>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"height: 24px;\">\n<td style=\"width: 15.0244%; height: 24px; vertical-align: top;\">\n<h4><span style=\"font-size: 10pt;\"><strong>Processes and infrastructure for transition and longitudinal care<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 24px; vertical-align: top;\"><span style=\"font-size: 10pt;\">1. Incorporate the <a href=\"https:\/\/www.gottransition.org\/resourceGet.cfm?id=208\" target=\"_blank\" rel=\"noopener noreferrer\" data-feathr-click-track=\"true\">Six Core Elements of Health Care Transition (HCT)<\/a>\u00a0 into the existing patient care processes.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">2. Provide appropriate resources to assist youth and their families through the HCT process.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">3. Develop programs for HCT and longitudinal care for young adults with hydrocephalus, or if geographic and resource constraints prevent the development of such programs, develop relationships with other HCT and longitudinal care programs so that patients can receive appropriate care.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">4. Ensure that all adults with hydrocephalus have access to a primary care medical home that has ready access to appropriate specialists to guide care management.<\/span><\/td>\n<td style=\"width: 31.4807%; height: 24px; border-style: none;\"><span style=\"font-size: 10pt;\">1. Support the development of clinical practice guidelines for hydrocephalus at all stages of life.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">2. Incorporate the <a href=\"https:\/\/www.gottransition.org\/resourceGet.cfm?id=208\" target=\"_blank\" rel=\"noopener noreferrer\">Six Core Elements of Health Care Transition<\/a> into clinical practice guidelines for patients with hydrocephalus, and encourage their adoption by pediatric and adult health care providers who provide care for patients with hydrocephalus.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">3. Promote the development of programs for health care transition and longitudinal care for youth with hydrocephalus throughout the United States and Canada, or, where this is not feasible, support the incorporation of youth with hydrocephalus into existing health care transition programs.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">4. Develop a HCT readiness assessment, medical summary\/transfer record, and self-care assessment for youth with hydrocephalus.<\/span><\/td>\n<td style=\"width: 23.2363%; height: 24px;\"><\/td>\n<\/tr>\n<tr style=\"height: 24px; background-color: #f5f5f5;\">\n<td style=\"width: 15.0244%; height: 24px; vertical-align: top;\">\n<h4><strong><span style=\"font-size: 10pt;\">Training<\/span><\/strong><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 24px;\"><\/td>\n<td style=\"width: 31.4807%; height: 24px; vertical-align: top;\"><span style=\"font-size: 10pt;\"><strong>Adult and Pediatric Neurosurgery and Neurology<\/strong><\/span><\/p>\n<p><span style=\"font-size: 10pt;\">1. Create learning objectives for pediatric and adult hydrocephalus within undergraduate medical education, and work with the <a href=\"https:\/\/www.aamc.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">AAMC<\/a> to incorporate these objectives into the medical school curriculum nationally.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">2. Develop curricular requirements for residency training via the <a href=\"https:\/\/www.acgme.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">ACGME<\/a> for the physiology, pathophysiology, and treatment of hydrocephalus, and for health care transition, and include these topics in self-assessment examinations.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">3. Include the topic of health care transition in board certification examinations.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">4. Address the \u201chidden curriculum\u201d that can create a culture within training and practice that adversely affects patients with hydrocephalus.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">5. Provide Continuing Medical Education opportunities for hydrocephalus and health care transition.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">6. Work with primary care professional societies to create educational products that will help primary care providers to participate in the care of youth and adults with hydrocephalus.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\"><strong>Nursing and Social Work<\/strong><\/span><\/p>\n<p><span style=\"font-size: 10pt;\">1. The <a href=\"https:\/\/aann.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">AANN<\/a> should create a standard curriculum for hydrocephalus, and work with the <a href=\"https:\/\/www.aacnnursing.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">American Association of Colleges<\/a> of Nursing to incorporate the curriculum into undergraduate nursing education.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">2. The <a href=\"https:\/\/sswlhc.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">SSWLHC<\/a> should encourage universities with schools of Social Work to include transition to adulthood education into healthcare-related curriculum.<\/span><\/p>\n<p>&nbsp;<\/td>\n<td style=\"width: 23.2363%; height: 24px;\"><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 15.0244%; height: 24px; vertical-align: top;\">\n<h4><span style=\"font-size: 10pt;\"><strong>Payment<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 24px;\"><\/td>\n<td style=\"width: 31.4807%; height: 24px;\"><\/td>\n<td style=\"width: 23.2363%; height: 24px;\"><span style=\"font-size: 10pt;\">1. Advocate for reassessment of the Relative Value Unites (RVUs) of surgical and medical care for patients with hydrocephalus so that reimbursement is commensurate with the effort required to provide this high-value care.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">2. Advocate for appropriate valuation of hydrocephalus treatment and longitudinal care in new payment models.<\/span><\/td>\n<\/tr>\n<tr style=\"height: 24px; background-color: #f5f5f5;\">\n<td style=\"width: 15.0244%; height: 24px; vertical-align: top;\">\n<h4><strong><span style=\"font-size: 10pt;\">Insurance<\/span><\/strong><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 24px;\"><\/td>\n<td style=\"width: 31.4807%; height: 24px;\"><\/td>\n<td style=\"width: 23.2363%; height: 24px;\"><span style=\"font-size: 10pt;\">1. Advocate for the retention of existing legislative and regulatory provisions that allow children to remain on their parents\u2019 insurance plan in early adulthood; prohibit insurers from discriminating against persons with pre-existing conditions; prohibit annual and lifetime limits on insurance payments; and require out of pocket spending limits<\/span><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 15.0244%; height: 24px; vertical-align: top;\">\n<h4><strong><span style=\"font-size: 10pt;\">Research<\/span><\/strong><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 24px;\"><\/td>\n<td style=\"width: 31.4807%; height: 24px; vertical-align: top;\"><span style=\"font-size: 10pt;\">1. Promote the funding of research in population health, health services, and health care economics of HCT and longitudinal care for youth with hydrocephalus, with the goal of providing data and economic models that can be used to assess the outcomes of different models of care.<\/span><\/td>\n<td style=\"width: 23.2363%; height: 24px;\"><span style=\"font-size: 10pt;\">1. Encourage the pediatric-focused <a href=\"https:\/\/hcrn.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">Hydrocephalus Clinical Research Network<\/a> (HCRN) and the <a href=\"https:\/\/www.ahcrn.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">Adult Hydrocephalus Clinical Research Network<\/a> (AHCRN) to define common data elements, and develop mechanisms for patients enrolled in the HCRN to be followed in the AHCRN after the age of 18 so that a detailed picture of the health care services and outcomes across the lifespan can be developed and used to improve care.<\/span><\/td>\n<\/tr>\n<tr style=\"height: 24px; background-color: #f5f5f5;\">\n<td style=\"width: 15.0244%; height: 24px; vertical-align: top;\">\n<h4><strong><span style=\"font-size: 10pt;\">Support and education of patients and families<\/span><\/strong><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 24px;\"><\/td>\n<td style=\"width: 31.4807%; height: 24px;\"><\/td>\n<td style=\"width: 23.2363%; height: 24px;\"><span style=\"font-size: 10pt;\">1. Develop and keep up-to-date a roster of clinics, programs and physicians who provide HCT and adult care in hydrocephalus in the United States and Canada.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">2. Develop and make available resources for health care transition specific for hydrocephalus.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">3. Develop and disseminate information about health care transition for teenagers and young adults.<\/span><\/p>\n<p><span style=\"font-size: 10pt;\">4. Promote the pursuit of an adult-focused primary care medical home.<\/span><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 15.0244%; height: 39px; vertical-align: top;\">\n<h4><span style=\"font-size: 10pt;\"><strong>Advocacy<\/strong><\/span><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 39px;\"><\/td>\n<td style=\"width: 31.4807%; height: 39px;\"><\/td>\n<td style=\"width: 23.2363%; height: 39px;\"><span style=\"font-size: 10pt;\">1. Work with medical specialty societies, nurses\u2019 organizations, hospital associations, national insurance associations, independent living associations, and disability rights groups to develop an advocacy agenda for HCT that can be implemented at federal, state, and regional levels.<\/span><\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 15.0244%; height: 24px; vertical-align: top; background-color: #f5f5f5;\">\n<h4><strong><span style=\"font-size: 10pt;\">Follow Up<\/span><\/strong><\/h4>\n<\/td>\n<td style=\"width: 30.2301%; height: 24px; background-color: #f5f5f5;\"><\/td>\n<td style=\"width: 31.4807%; height: 24px; background-color: #f5f5f5;\"><\/td>\n<td style=\"width: 23.2363%; height: 24px; background-color: #f5f5f5;\"><span style=\"font-size: 10pt;\">1. Convene a follow-up Transition Summit in about 2023.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-size: 10pt;\">* 1\/ Recommendations in the purview of professional societies in adult and pediatric neurosurgery and neurology are reflected in Williams MA, van der Willigen T, White P, Wood D, Cartwright C, \u201cImproving Health Care Transition and Longitudinal Care for Adolescents and Young Adults with Hydrocephalus: Report from the Hydrocephalus Association Transition Summit\u201d,\u00a0Journal of Neurosurgery\u00a0(forthcoming).<\/span><\/p>\n<div id=\"attachment_22692\" style=\"width: 160px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/www.hydroassoc.org\/docs\/TransitionSummit\/Transition%20Summit%20Recommendations.pdf\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-22692\" class=\"wp-image-22692\" src=\"https:\/\/www.hydroassoc.org\/wp-content\/uploads\/2018\/07\/Screen-Shot-2018-07-12-at-1.08.03-PM-300x232.png\" alt=\"HA Transition Initiative Action Plan\" width=\"150\" height=\"116\" \/><\/a><p id=\"caption-attachment-22692\" class=\"wp-caption-text\">Click here to download a detailed copy of the Action Plan.<\/p><\/div>\n\r\n            <div id=\"daexthefup-container\"\r\n                 class=\"daexthefup-container daexthefup-layout-stacked daexthefup-alignment-center\"\r\n                 data-post-id=\"456\">\r\n\r\n                <div class=\"daexthefup-feedback\">\r\n                    <div class=\"daexthefup-text\">\r\n                        <h3 class=\"daexthefup-title\">Was this resource helpful?<\/h3>\r\n                    <\/div>\r\n                    <div class=\"daexthefup-buttons-container\">\r\n                        <div class=\"daexthefup-buttons\">\r\n\t\t\t\t\t\t\t\r\n            <div class=\"daexthefup-yes daexthefup-button daexthefup-button-type-text\" data-value=\"1\">\r\n                <div class=\"daexthefup-button-text\">Yes<\/div>\r\n            <\/div>\r\n\r\n\t\t\t\t\t\t\t\t\t\t\r\n            <div class=\"daexthefup-no daexthefup-button daexthefup-button-type-text\" data-value=\"0\">\r\n                <div class=\"daexthefup-button-text\">No<\/div>\r\n            <\/div>\r\n\r\n\t\t\t                        <\/div>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                <div class=\"daexthefup-comment\">\r\n                    <div class=\"daexthefup-comment-top-container\">\r\n                        <label id=\"daexthefup-comment-label\" class=\"daexthefup-comment-label\"><\/label>\r\n\t\t\t\t\t\t                            <div class=\"daexthefup-comment-character-counter-container\">\r\n                                <div id=\"daexthefup-comment-character-counter-number\"\r\n                                     class=\"daexthefup-comment-character-counter-number\"><\/div>\r\n                                <div class=\"daexthefup-comment-character-counter-text\"><\/div>\r\n                            <\/div>\r\n\t\t\t\t\t\t                    <\/div>\r\n                    <textarea id=\"daexthefup-comment-textarea\" class=\"daexthefup-comment-textarea\"\r\n                              placeholder=\"Type your message\"\r\n                              maxlength=\"400\"><\/textarea>\r\n                    <div class=\"daexthefup-comment-buttons-container\">\r\n                        <button class=\"daexthefup-comment-submit daexthefup-button\">Submit<\/button>\r\n                        <button class=\"daexthefup-comment-cancel daexthefup-button\">Cancel<\/button>\r\n                    <\/div>\r\n                <\/div>\r\n\r\n                <div class=\"daexthefup-successful-submission-text\">Thanks for your feedback!<\/div>\r\n\r\n            <\/div>\r\n\r\n\t\t\t","protected":false},"excerpt":{"rendered":"<p>A major milestone in a young adult living with hydrocephalus is the transition from pediatric to adult medical care. Learn about the HA Transition Initiative.<\/p>\n","protected":false},"author":6,"featured_media":37240,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_helpful_pro_status":1,"_searchwp_excluded":"","inline_featured_image":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[4,1182,1207,1127],"tags":[1213],"post_folder":[1099],"class_list":["post-456","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-article","category-rating","category-resources","category-transitioning-to-adult-care","tag-transitioning-to-adult-healthcare"],"acf":[],"jetpack_featured_media_url":"https:\/\/www.hydroassoc.org\/wp-content\/uploads\/2020\/03\/Ft-Image-for-Blogs-and-SYS-300x240-11.png","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/posts\/456","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/comments?post=456"}],"version-history":[{"count":0,"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/posts\/456\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/media\/37240"}],"wp:attachment":[{"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/media?parent=456"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/categories?post=456"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/tags?post=456"},{"taxonomy":"post_folder","embeddable":true,"href":"https:\/\/www.hydroassoc.org\/wp-json\/wp\/v2\/post_folder?post=456"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}