Paediatrics Resident University of Toronto Mississauga, Ontario, Canada
Background: Transitioning youth with medical complexity (YMC) from pediatric to adult health care poses significant challenges, demanding extensive effort and collaboration among the pediatric team, family physician (FP), YMC and their caregivers. Objective: The objectives of this study are to: 1) assess the feasibility and acceptability of implementing tri-partnership virtual handovers involving the pediatric team, FP and YMC/caregivers, and 2) explore participant experiences with the tri-partnership virtual handover. Design/Methods: A descriptive, pre-post, mixed methods, prospective study design was utilized. Ethics approval was obtained, following which 20 tri-partnership virtual handovers were conducted from 2021-2023. Caregivers of transition-age YMC and pediatric team members were recruited from a Complex Care program at a tertiary pediatric hospital. FP were recruited based on family identified FP.
The intervention consisted of a 45-60 minute meeting involving the pediatric team (nurse practitioner and pediatrician), FP, caregiver and other relevant providers. This tri-partnership virtual handover served as a platform to prepare for transition and encompassed a comprehensive review of: (1) the YMC’s personalized care plan, medications and technologies, (2) sub-specialist referrals, (3) allied health and community resources, (4) funding applications, and (5) questions and action items.
Caregivers and FPs completed a post-handover questionnaire to explore their satisfaction with the intervention. Semi-structured qualitative interviews were conducted with caregivers, FPs and pediatric team members to understand their perceptions of the intervention.
Quantitative data will be analyzed using descriptive statistics to assess the feasibility and acceptability of the intervention, against a set of a priori criteria. Qualitative data will be analyzed using a content analysis approach, wherein two researchers will independently code interview transcripts to identify key concepts, categories and refine them to provide insight into the tri-partnership virtual handover experience.
