A medical assistant-facilitated transition activity in a pediatric cardiology clinic

Formal transition programs prepare pediatric patients with congenital heart disease (CHD) for successful lifelong management of their disease. Conducting transition program activities in pediatric cardiology clinics can be a challenge if there are limited resources. The purpose of this study was to test the effectiveness of a medical assistant (MA)-facilitated transition activity in increasing documentation of transition discussions and characterize staff acceptability of this intervention.

We performed a prospective exploratory study over a five-week period. CHD patients aged 13 and older presenting for routine pediatric cardiology follow-up appointments received a prompt from the MA to view a list of 17 transition topics from which to choose topics for discussion with the pediatric cardiologist during the clinic visit. Historical control group data were collected from the same period, two years prior. We compared the presence of documentation of transition discussions between the transition activity and control group using comparative statistics. Staff acceptability was assessed using the revised Treatment Acceptability and Preference Questionnaire.

A total of 14 staff members participated in the transition activity involving 29 patients. Significantly more transition discussions were documented in the transition activity group compared with the historic control group (p < 0.001). Patients discussed more transition topics (median = 5, Interquartile range 2-7) than what was requested (median = 2, Interquartile range 1-4). All staff rated the activity as acceptable (ranging from 'somewhat acceptable' to 'very much acceptable') and were willing to continue after the study ended.

Having an MA-facilitated transition activity increased documentation of transition discussions in the pediatric cardiology clinic. Staff were accepting and in favor of continuing this low-resource activity.