Incorporating Healthcare Transition Readiness Assessment

  • Lisa A. Schwartz
  • Alexandra M. Psihogios
  • Emily M. Fredericks


Transition readiness assessment is defined as the measurement of indicators that an adolescent or young adult with special health-care needs (AYASHCN) can successfully initiate, continue, and finish the process of transferring from pediatric-centered to adult-centered medical care. Despite national research and clinical initiatives focused on the promotion of transition readiness, there is evidence that routine transition readiness assessment is not in place for many AYASHCN and their families, ultimately posing risks for inadequate health-care utilization, morbidity, and mortality. Challenges to transition readiness assessment include the lack of well-validated measures, inadequate resources and training, and difficulties with care coordination across providers. In this chapter, we define transition readiness using an evidenced-based, social-ecological framework—the Social-ecological Model of AYA Readiness to Transition (SMART)—and provide an updated review of the available transition readiness assessment measures. We describe ways in which emerging transition readiness assessment research may be incorporated into routine clinical practice through quality improvement science. Finally, we discuss limitations of the current literature and provide opportunities for future research, including the need for rigorous validation studies with attention to multiple transition stakeholders, to develop psychometrically robust measures with strong clinical utility.


Assessment Transition readiness Validity Adolescent/young adults (AYA) 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Lisa A. Schwartz
    • 1
    • 2
  • Alexandra M. Psihogios
    • 1
  • Emily M. Fredericks
    • 3
    • 4
  1. 1.Division of OncologyThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Perelman School of Medicine of the University of PennsylvaniaPhiladelphiaUSA
  3. 3.C.S. Mott Children’s HospitalAnn ArborUSA
  4. 4.University of Michigan Medical SchoolAnn ArborUSA

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