Improving Adolescent Health Care Transition: Piloting the Transition Readiness Assessment Questionnaire

Purpose. Successful adolescent health care transition (HCT) is a vital process in providing developmentally appropriate care and minimizing negative outcomes, especially in adolescents with special health care needs. The purpose of this mixed-methods quality improvement project was to pilot the Transition Readiness Assessment Questionnaire (TRAQ) tool in a pediatric rheumatology clinic and assess its utility as a transition tool as well as to inquire about specific patient and family-based transition needs. Methods. The TRAQ tool and follow-up survey were administered in dyads to all established pediatric rheumatology patients between the ages of 12-18, and one caregiver, who presented to the clinic during the two-month intervention period. A post-intervention interview with the treating team was also conducted to assess provider experience. Results. 29/30 paired TRAQ and surveys returned with overall acceptance of the tool across adolescents, caregivers and providers. 84% of adolescents and 91.3% of caregivers agreed that they were seeking greater independence for themselves or their child and the skills listed on TRAQ would help them take care of themselves. Caregivers found the TRAQ easier to fill out, understand and more helpful as a transition tool than the adolescents. The treatment team reported the TRAQ was useful in starting a conversation about transition and highlighted the need for a structured transition process. Conclusions.The TRAQ is an accepted and valuable HCT tool for adolescents, caregivers and providers. Future projects could be aimed at piloting the TRAQ or other readiness assessment tools in other sub-specialty clinics, building a transition framework to support utilization of transitional tools and addressing the transition themes identified by adolescents and their caregivers