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Center‐Based Quality Initiative Targets Youth Preparedness for Medical Independence: HEMO‐Milestones Tool in a Comprehensive Hemophilia Clinic Setting
Author(s) -
Croteau Stacy E.,
Padula Maura,
Quint Kate,
D'Angelo Loren,
Neufeld Ellis J.
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25807
Subject(s) - medicine , preparedness , subspecialty , documentation , medical home , curriculum , developmental milestone , intervention (counseling) , quality management , family medicine , medical education , nursing , pediatrics , psychology , pedagogy , management system , primary care , management , political science , computer science , law , economics , programming language
Background Patient transition readiness self‐assessment tools and investigation into patient and parent perceptions of the transition process from pediatric to adult care models have informed recognition of gaps in care, particularly for those with chronic disease. Implementation of a longitudinal transition process with patient tracking provides the opportunity for individualized education and skill building and fosters a patient‐centered model. Procedure Quality improvement intervention was used to assess and improve our transition process at annual comprehensive clinic visits for patients with bleeding disorders at our tertiary care pediatric center. Results Thirty‐one patients with rare bleeding disorders received an introduction to the transition process using the HEMO‐milestones tool in our hemophilia comprehensive clinic from September to December 2014. The percentage of patients with documented, age‐specific hemophilia knowledge/skill assessment increased from 21% to 97%. The percentage of patients with documented skill building or adult care transfer plan increased from 55% to 93%. Designated postclinic team debriefings facilitated the creation of collaborative documentation summarizing each patient's transition readiness and plan for continued skill building. Conclusions The HEMO‐milestones tool promotes a standardized approach to evaluation of self‐management competency. When combined with a collaborative multidisciplinary effort, it increases plans for skill building in patients with hemophilia. This tool is easily modifiable for alternate subspecialty use and does not require extensive training for implementation.