Preparing the Adult Practice to Accept Adolescents and Young Adults

  • Marybeth R. Jones
  • Marilyn Augustine
  • Brett W. Robbins


High-quality adult health care requires productive interactions between a practice team and patients. Patients need the information, skills, and confidence to make best use of their involvement with their practice team. Practice teams must have the expertise, relevant patient information, time, and resources to ensure effective clinical and behavioral management. When accepting an adolescent and young adult with special healthcare needs (AYASHCN) into a practice, it is essential to prepare the practice team to meet the unique needs of this population. This chapter reviews the specific steps required to establish a self-sustaining transition structure and process within an adult (receiving) practice.


  1. 1.
    Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff. 2001;20(6):64–78.CrossRefGoogle Scholar
  2. 2.
    White P, Cooley WC, McAllister J. Starting a transition improvement process using the six core elements of health care transition. Got Transition Practice Resource. 2015. Accessed 18 May 2017.
  3. 3.
    Dovey-Pearce G, Hurrell R, May C, Walker C, Doherty Y. Young adults’ (16–25 years) suggestions for providing developmentally appropriate diabetes services: a qualitative study. Health Soc Care Community. 2005;13(5):409–19.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Chu P, Maslow G, vonIsenburg M, Chung R. Systematic review of the impact of transition interventions for adolescents with chronic illness on transfer from pediatric to adult healthcare. J Pediatr Nurs. 2015;30:e19–27.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Transitions Clinical Report Authoring Group. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2011;128(1):182–200.CrossRefGoogle Scholar
  6. 6.
    Greenlee MC, D’Angelo L, Harms SR, Kuo AA, Landry M, McManus M, Talente GM, White P, American College of Physicians Council of Subspecialty Societies Pediatric to Adult Care Transitions Initiative Steering Committee. Enhancing the role of internists in the transition from pediatric to adult health care. Ann Intern Med. 2017;166(4):299–300.PubMedCrossRefGoogle Scholar
  7. 7.
    McManus M, White P, Barbour A, et al. Pediatric to adult transition: a quality improvement model for primary care. J Adolesc Health. 2015;56:73–8.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Beresford B, Stuttard L. Young adults as users of adult healthcare: experiences of young adults with complex or life-limiting conditions. Clin Med (Lond). 2014;14(4):404–8.CrossRefGoogle Scholar
  9. 9.
    Summary Health Statistics: National Health Interview Survey. 2014. Table 16a. Accessed 14 July 2017.
  10. 10.
    Fortuna RJ, Robbins BW, Halterman JS. Ambulatory care among young adults in the United States. Ann Intern Med. 2009;151(6):379–85.PubMedCrossRefGoogle Scholar
  11. 11.
    Fortuna RJ, Robbins BW, Mani N, Halterman JS. Dependence on emergency care among young adults in the United States. J Gen Intern Med. 2010;25(7):663–9.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Prior M, McManus M, White P, Davidson L. Measuring the “triple aim” in transition care: a systematic review. Pediatrics. 2014;134(6):e1648–61.CrossRefGoogle Scholar
  13. 13.
    Fair C, Cuttance J, Sharma N, Maslow G, Wiener L, Betz C, Porter J, McLaughlin S, Gilleland-Marchak J, Renwick A, Naranjo D, Jan S, Javalkar K, Ferris M, International and Interdisciplinary Health Care Transition Research Consortium. International and interdisciplinary identification of health care transition outcomes. JAMA Pediatr. 2016;170(3):205–11.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Suris JC, Akre C. Key elements for, and indicators of, a successful transition: an international Delphi study. J Adolesc Health. 2015;56(6):612–8.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Okumura MJ, Heisler M, Davis MM, Cabana MD, Demonner S, Kerr EA. Comfort of general internists and general pediatricians in providing care for young adults with chronic illnesses of childhood. J Gen Intern Med. 2008;23(10):1621–7.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Tuchman LK, Slap GB, Britto MT. Transition to adult care: experiences and expectations of adolescents with a chronic illness. Child Care Health Dev. 2008;34(5):557–63.PubMedCrossRefGoogle Scholar
  17. 17.
    McLaughlin SE, Machan J, Fournier P, Chang T, Even K, Sadof M. Transition of adolescents with chronic health conditions to adult primary care: factors associated with physician acceptance. J Pediatr Rehabil Med. 2014;7(1):63–70.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Marybeth R. Jones
    • 1
  • Marilyn Augustine
    • 2
  • Brett W. Robbins
    • 3
  1. 1.Division of General PediatricsUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Division of Endocrinology and MetabolismUniversity of Rochester Medical CenterRochesterUSA
  3. 3.Division of Adolescent MedicineUniversity of Rochester Medical CenterRochesterUSA

Personalised recommendations