The 10 Steps Transition Pathway: Improving Transition for Children in Hospital Settings

Background: Health transition from children‟s to adult services has been recognised as an important aspect of quality and service improvement for many years. However, transition for young people remains a disruptive experience for everyone involved. Alder Hey Children‟s NHS Foundation Trust is one of the busiest children‟s hospitals in Europe and its transition arrangement had been identified as an area for improvement within a previous CQC report. Aims and Objectives: The paper outlines a project to develop a 10 step transition pathway for a complex cohort of young people that was produced as part of a care quality improvement programme at Alder Hey. Methods: We used a mixed method approach to capture views and opinions of members of staff at engagement events and utilised a survey instrument to collect perceptions of key professionals on the barriers and facilitators of good transition. The analysis of data was then used to develop a ten step transition pathway and protocol. Findings: The transition improvement programme and development of the transition pathway brought about an increased understanding about the barriers and challenges of transition work. It demonstrated what is and isn‟t working well, where policies conflict or practice inconsistencies exist across the trust between different specialties. Conclusions and Implications for Practice: The project showed the clear need of a key worker or lead consultant for each individual. The pathway identifies a 10 step protocol which lists key steps to be taken by those key workers to ensure a successful transition. The protocol developed was seen as a useful resource to plan transition pathways for children with complex care needs.