Strategic Priority
Primary and Community CareLead
Dr. Sandra WhitehouseAim: To improve coordinated youth to adult transition, for patients with chronic health conditions and disabilities.
Summary: The issue of transition is a challenge across jurisdictions in Canada and internationally with no clearly successful model in place. Progress is limited by the many types of providers and institutions involved and the fact that there is no single entity responsible for moving youth transition forward. Ensuring that youth with CHC/Ds remain attached and engaged with FPs while also receiving care from community and subspecialty paediatricians requires role clarity amongst the three communities of practices, appropriate physician fee schedules to support referral, clinical practices that are mutually supportive, and the efficient flow of documentation and information. Next steps could be engagement of a representative group of specialist physicians, FPs, and other stakeholders to map out a consensus approach to improving transition for youth with CHC/Ds. This could include one or more of: further/ongoing TCMP development and updating, a support call-in line, additional education module development, additional communication and engagement, and further research and evaluation.
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iPad and special app opens communication lines between doctors and children
