Inpatient Pediatric-to-Adult Transition of Care Consultation Delivery: A Mixed-Methods Study

OBJECTIVE: We evaluated an inpatient transition consultation (ITC) for adolescents and young adults (AYAs) with chronic conditions and their caregivers admitted to the hospital to assess ITC content, evaluate how it addressed transition concerns, determine its impact, and identify areas for improvement. PATIENTS AND METHODS: We conducted a mixed-methods study at a tertiary academic medical center. Eligible participants were English-speaking patients aged 18 years or older and/or their caregivers who received an ITC during hospitalization. The ITC was conducted by a physician who focused on assessing transition readiness, providing education and counseling, and planning the transition from pediatric to adult models of care. Data collection included semistructured interviews and a modified Adolescent Assessment of Preparation for Transition (ADAPT) survey. Interviews explored perceptions of the ITC, including the content covered, impact and accountability of the consult, and suggestions for improvement. Qualitative data were analyzed using inductive coding; survey responses were summarized descriptively. RESULTS: Twelve participants representing diverse chronic conditions completed interviews and surveys. Five themes were generated: "enhanced understanding of self-management in adult care," "anxiety regarding anticipated changes from pediatric to adult care delivery," "reassurance and reduced anxiety following consultation," "importance of support systems for patients and caregivers undergoing transition," and "centering holistic, person-focused care during transition." CONCLUSIONS: An ITC was perceived as educational, reassuring, and patient-centered. Findings suggest that targeted transition counseling during hospitalization is acceptable to patients and caregivers and may help reduce anxiety surrounding health care transition.