Handing off hope: transition of care in pediatric surgery

The importance of transitioning care from pediatric to adult practitioners is an often overlooked aspect of chronic disease. The benefits of a planned transition in health care are that patients will learn valuable life-long lessons on healthcare maintenance, when and how to seek medical attention for new issues that may arise, and improvements on their overall well-being. The purpose of this SAGES White Paper was to summarize the available knowledge for several pediatric surgical conditions to aid in transition of care for this patient population.

The members of the SAGES Pediatric Surgery Committee elected to produce this White Paper. The group chose to focus on several important gastrointestinal diseases that may require lifelong care: tracheoesophageal fistula, duodenal atresia, anorectal malformations, childhood obesity, and gastrointestinal malignancies. For each disease process a summary of long term issues facing these patients, stakeholders involved, and follow up recommendations if required were identified.

Each disease process has its own unique set of long-term issues as well as multidisciplinary stakeholders and need for follow-up. However, individualized care is needed based on each patient's unique needs. To facilitate consistent transfer of care standardization is needed for surgical diseases. Key aspects of standardization include identifying a multidisciplinary team, working towards consistent quality improvement, and implementation of policy guided processes with individual treatment plans.

Continued work in standardizing transition of care is required for optimal treatment of this complex patient population.