Transitions of Care: Pediatric to Adult

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"> <a class="a2a_button_print" aria-label="Print" style="padding:0;"> <svg class="connect__social-icon" role="img" aria-label="print"> <title> print </title><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/assets/img/common/svg-sprite.svg#social-print"> </use> </svg> </a> </li> </ul> </section> <div class="rich-text end-page-header"> <h1>Transitions of Care</h1> <p class="subtitle">Managing pediatric to adult transitions of care</p> </div> <div class="rich-text"> <section class="rich-text__embed l-pull-right"> <section class="end-image-block js-image-block"> <figure class="end-image-block__media" aria-labelledby="caption-66e689e3-902f-4550-a017-76771880001b"> <div class="end-image-block__image"> <picture> <source srcset="/-/media/endocrine/images/clinical-practice/hhn.jpg?w=1290&hash=263527D5EE62B7222D7CA11562DF3482 1x, /-/media/endocrine/images/clinical-practice/hhn.jpg?w=2580&hash=462B2A1856A8ADCEB0A39FC96D50470F 2x" media="(min-width: 56.9375em )"></source> <source srcset="/-/media/endocrine/images/clinical-practice/hhn.jpg?w=910&hash=8277C56BA178FB59B6B43F7080B9BB89 1x, /-/media/endocrine/images/clinical-practice/hhn.jpg?w=1820&hash=89CF053F52B2686062FD4D6F962BEA68 2x" media="(min-width: 29.4375em )"></source> <source srcset="/-/media/endocrine/images/clinical-practice/hhn.jpg?w=470&hash=A133E9B458189A388EEE37443552ABE2 1x, /-/media/endocrine/images/clinical-practice/hhn.jpg?w=940&hash=0DE016B66768B7CE43E8E06D810349E4 2x" media="(max-width: 29.375em )"></source> <img src="/-/media/endocrine/images/clinical-practice/hhn.jpg?la=en&h=754&w=1290&hash=069B4D9CC3006633A5186232A0A0A7CA" alt="Hormone.org" style="width:100%" srcset="/-/media/endocrine/images/clinical-practice/hhn.jpg?w=190&hash=ECC379F17F8A7D640F04EE84CF256AAE 1x, /-/media/endocrine/images/clinical-practice/hhn.jpg?w=380&hash=C0893BBEC086A11A4B2A9B6E48EE31A6 2x"> </picture> </div> <figcaption id="caption-66e689e3-902f-4550-a017-76771880001b"> </figcaption> </figure> </section> </section> <p id="top">Transitioning from a pediatric to an adult provider can be a challenge for all members of the care team. Transitions toolkits have been developed for <a href="#t1d">Type 1 Diabetes</a>, <a href="#ghd">Growth Hormone Deficiency</a>, <a href="#ts">Turner Syndrome</a> and <a href="#th">Transgender Health</a> to help ease this transition.</p> <h3 id="t1d">Type 1 Diabetes</h3> <ul> <li><a href="/-/media/endocrine/files/practice/provider_assessment_skill_set.pdf">Provider Assessment of Patient Skill Set <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: A checklist to help the pediatric care team begin a conversation with the patient about what they need to do to successfully manage their diabetes without parental supervision.</li> <li><a href="/-/media/endocrine/files/practice/selfassessment.pdf">Patient Self-assessment of Worries, Concerns, and Burdens <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: An assessment of relevant psycho-social, familial, and cognitive factors that the adult care team should be aware of when caring for their new patient.</li> <li><a href="/improving-practice/transitions/t1d/planning-for-pediatric-practices">Recommended Approach to Planning for Pediatric Practices</a>: Pediatric practices with a guide for how to begin the transition process for patients with type 1 diabetes.</li> <li><a href="/-/media/endocrine/files/practice/clinical_summary.pdf">Clinical Summary</a> <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x">: A template for the pediatric care provider to summarize the patient鈥檚 medical record, which is then transferred to the adult care provider.</li> <li><a href="/improving-practice/transitions/t1d/planning-for-adult-practices">Recommended Approach to Receiving a New Patient</a>: Receiving suggestions for the adult provider and includes information on how to begin the final phase of the transition.</li> <li><a href="/improving-practice/transitions/t1d/welcome-to-the-practice">"Welcome to the Practice" Guide</a>: A tool for developing practice resources to be given to new patients with information on transportation, after-hours contact information, lab testing/results, etc.</li> <li><a href="/-/media/endocrine/files/practice/visitor_information.pdf">Visitor Information Form <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: A form for use by the emerging adult when first seeing their new provider to let them know who can be informed of personal health information or be allowed in the room during examination.</li> </ul> <p style="text-align: center;">* <a href="#top">top</a> *</p> <h3 id="ghd">Growth Hormone Deficiency</h3> <ul> <li><a href="/-/media/endocrine/files/practice/ghd_physician_assessment_patient_skill_set.pdf">Assessment of Patient Skills <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: A checklist to help the pediatric care team begin a conversation with the patient about what they need to do to successfully manage their growth hormone deficiency without parental supervision.</li> <li><a href="/-/media/endocrine/files/practice/ghd_patient_assessment.pdf">Patient Self-assessment of Worries, Concerns, and Burdens <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: An assessment of relevant psycho-social, familial, and cognitive factors that the adult care team should be aware of when caring for their new patient.</li> <li><a href="/-/media/endocrine/files/practice/ghd_clinical_summary.pdf">Clinical Summary <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: A template for the pediatric care provider to summarize the patient鈥檚 medical record, which is then transferred to the adult care provider.</li> <li><a href="/improving-practice/transitions/ghd/planning-for-adult-practices">Recommended Approach to Receiving a New Patient</a>: A resource for the adult provider and includes information on how to begin the final phase of the transition.</li> <li><a href="/-/media/endocrine/files/practice/ghd_dosing_of_gh.pdf">Dosing Guide <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: An overview of dosing strategies for patients with growth hormone deficiency.</li> </ul> <p style="text-align: center;">** <a href="#top">top</a> **</p> <h3 id="ts">Turner Syndrome</h3> <ul> <li><a href="/improving-practice/transitions/turner-syndrome/provider-assessment-of-skill-set">Provider Assessment of Patient Skill Set</a>: This tool helps pediatricians to assess a young adult鈥檚 knowledge and skills regarding Turner Syndrome and its management in preparation for their transition to adult care providers.</li> <li><a href="/-/media/endocrine/files/practice/ts_transition_readiness_assessment.pdf">Transition Readiness Assessment</a> <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x">: An assessment tool for adult care providers to identify gaps in self-care knowledge and skills, and to discuss any of these issues with their patients to ensure optimal management of their medical condition.</li> <li><a href="/-/media/endocrine/files/practice/ts_clinical_summary_transfer_record.pdf">Clinical Summary & Transfer Record <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: A form to ensure that all essential clinical information related to the patient鈥檚 condition is included in their medical record upon transfer to adult practice. It must be completed by the referring provider and patient.</li> <li><a href="/improving-practice/transitions/turner-syndrome/dosing-standards-for-estrogen">Dosing Standards for Estrogen</a>: A guide for both pediatric and adult providers with an overview of dosing strategies for patients with Turner Syndrome.</li> <li><a href="/improving-practice/transitions/turner-syndrome/planning-for-adult-practices">Recommended Approach for Transitioning into Adult Practice</a>: A resource for adult providers who plan to receive emerging adults with Turner Syndrome.</li> <li><a href="/improving-practice/transitions/turner-syndrome/planning-for-pediatric-practices">Recommended Approach for Planning for Pediatric Practices</a>: A resource for pediatricians who are preparing to transition their young adult patients with Turner Syndrome to an adult provider.</li> <li><a href="/-/media/endocrine/files/practice/ts_adult_care_recommendations.pdf">Adult Care Recommendations for Screening & Assessment <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: A chart to inform patients about which provider should be responsible for conducting various screenings and other assessments needed in adulthood.</li> </ul> <p style="text-align: center;">*** <a href="#top">top</a> ***</p> <h3 id="th">Transgender Health</h3> <ul> <li><a href="/-/media/endocrine/files/practice/gender_provider_assessment_skill_set.pdf">Provider Assessment of Skill Set <strong><img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></strong></a><strong>: </strong>This tool helps pediatricians to assess a young adult鈥檚 knowledge and skills regarding transgender medical care and its management in preparation for their transition to adult care providers.</li> <li><a href="/-/media/endocrine/files/practice/gender_transition_readiness_assessment.pdf">Transition Readiness Assessment <strong><img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></strong></a><strong>: </strong>An assessment tool for adult care providers to identify gaps in self-care knowledge and skills, and to discuss any of these issues with their patients to ensure optimal management.</li> <li><a href="/-/media/endocrine/files/practice/gender_clinical_summary_transfer_record.pdf">Clinical Summary and Transfer Record<strong> <img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></strong></a><strong>: </strong>A form to ensure that all essential clinical information related to the patient is included in their medical record upon transfer to adult practice.</li> <li><a href="/-/media/endocrine/files/practice/gender_dosing_standards_transgender_youth.pdf" target="_self">Dosing Standards for Pubertal Suppression and Sex Steroid Hormones in Transgender Youth</a> <strong><a href="/-/media/endocrine/files/practice/gender_dosing_standards_transgender_youth.pdf"></a><a style="background-color: #ffffff;" href="/-/media/endocrine/files/practice/gender_dosing_standards_transgender_youth.pdf" target="_self"><img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: </strong>A guide for both pediatric and adult providers with an overview of dosing strategies for patients with Gender Incongruence/Gender Dysphoria.</li> <li><a href="/-/media/endocrine/files/practice/gender_planning_for_adult_practices.pdf" target="_self">Planning for Adult Practices</a> <strong><a href="/-/media/endocrine/files/practice/gender_planning_for_adult_practices.pdf"></a><a style="background-color: #ffffff;" href="/-/media/endocrine/files/practice/gender_planning_for_adult_practices.pdf" target="_self"><img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: </strong>This document provides recommendations for adult endocrinology providers to aid in the transition of young transgender adults.</li> <li><a href="/-/media/endocrine/files/practice/gender_planning_for_pediatric_practices.pdf" target="_self">Planning for Pediatric Practices</a> <strong><a style="background-color: #ffffff;" href="/-/media/endocrine/files/practice/gender_planning_for_pediatric_practices.pdf" target="_self"><img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: </strong>This document provides recommendations for pediatric endocrinology providers to aid in the transition of young transgender adults.</li> <li><a href="/-/media/endocrine/files/practice/gender_adult_care_recommendations.pdf" target="_self">Adult Care Recommendations</a> <strong><a style="background-color: #ffffff;" href="/-/media/endocrine/files/practice/gender_adult_care_recommendations.pdf" target="_self"><img alt="PDF" src="/-/media/images/icons/formatpdf.gif" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: </strong>A chart to inform patients about which provider should be responsible for conducting various screenings and other assessments needed in adulthood.</li> <li><a href="/-/media/endocrine/files/practice/hhn_-patient-infographic.pdf" target="_self">Patient Resource </a><strong><a style="background-color: #ffffff;" href="/-/media/endocrine/files/practice/hhn_-patient-infographic.pdf" target="_self"><img style="height: 16px; width: 16px;" alt="PDF" src="/-/media/images/icons/formatpdf.gif?h=16&w=16&hash=75AD426D0864BAC8F288D21C5A930C3F" srcset="/-/media/images/icons/formatpdf.gif?w=16&h=16&hash=75AD426D0864BAC8F288D21C5A930C3F 1x"></a>: </strong>This patient education infographic serves as a starting place to educate patients on what they will need to transition care.</li> </ul> <p style="text-align: center;">** <a href="#top">top</a> **</p> <div class="end-more-text js-more-text"> </div> </div> <div class="end-page-meta"> </div> </div> </div> <div class="container__col"> <div class="container__inner"> <nav class="end-lp-secondary-nav js-secondary-nav" style=transform:translateY(52px);margin-bottom:52px; aria-label="Site Sub navigation"> <a href="" class="end-lp-secondary-nav__toggle js-nav-toggle"> <span></span> More in this section </a> <a href="/improving-practice"> <h6 class="end-lp-secondary-nav__title js-menu-title">IMPROVING PRACTICE</h6> </a> <ul class="end-lp-secondary-nav__menu js-menu"> <li class="end-lp-secondary-nav__item "> <div class="end-lp-secondary-nav__category no-icon"> <a 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