Transition from paediatric surgery: how many patients do we need to plan for?

Area of Science:

• Pediatric Surgery
• Healthcare Management
• Adolescent Health

Background:

• Transitional care for pediatric surgical patients moving to adult services is an identified National Health Service (NHS) priority.
• New guidance from the National Institute for Health and Care Excellence (NICE) emphasizes the need for quality care continuity into adulthood.
• Evaluation of departmental activity was conducted to assess the scale of the transitional care issue in pediatric surgery.

Purpose of the Study:

• To evaluate the magnitude of the transitional care issue within a tertiary pediatric surgery department.
• To identify the number of adolescent patients requiring transition to adult care services.
• To determine if specific surgical subspecialties have a higher proportion of patients needing transition.

Main Methods:

• Retrospective review of outpatient appointments for general pediatric surgery over a 12-month period.
• Identification of patients aged 15 years and older requiring transition to adult care.
• Recording of the appropriate adult team for referral for identified patients.

Main Results:

• A total of 2989 general pediatric surgery clinic appointments were reviewed.
• 289 appointments (9.7%) were for patients aged 15 years or older.
• 62 patients (28% of those ≥ 15 years) required transition to adult care, with significantly more from colorectal surgery (P = 0.0009).

Conclusions:

• A higher-than-anticipated number of pediatric surgical patients require transition to adult care.
• Colorectal surgery patients represent a priority group needing enhanced transitional services.
• Implementing best practices, including joint clinics and inter-departmental collaboration, is vital for quality adolescent care.