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Show Adolescents and young adults (AYA) with special healthcare needs transitioning to adult care: A needs assessment, with an emphasis on rural communities Whitney Tiatia, BSN, RN; Chelsea Ghena, DNP, RN; Jennifer Hamilton, DNP, APRN, CPNP-PC, PMHS Key Take Away: Barriers to accepting AYA with special healthcare needs must be addressed to ensure . adequate healthcare for this population Background • In Utah, 15.5% of children have special healthcare needs • 86.6% of adolescents did not receive the services necessary to transition to adult healthcare • Children with special healthcare needs are increasing at a rate of about 5% every year Purpose Needs assessment for adult providers in Utah, with an emphasis on rural communities, who are willing to care for AYA with special health care needs Methods Barriers when transferring Barriers when accepting n= 7 7 n= 5 n= 5 5 4.5 n= 5 6 4 n= 4 5 3.5 3 4 n= 2 2.5 3 2 2 1.5 1 1 0.5 0 • Needs assessment which conducted informal discussions, held one- on- one with primary care providers who specialize in the transition of AYA with special healthcare needs to review current policies, procedures, and trends. • A survey was created and sent out to 408 PCPs across one institution in an Intermountain West state that included rural, suburban, and urban locations. • Develop a business case and cost analysis. Training and/or experience gaps Lack of time in appointments Lack of provider hand off ‘No training on this in past years at medical school. Normalizing this while in medical school is a critical missing piece.’ • Internal medicine 0 Lack of available adult providers ‘Access is a barrier for everyone in the adult world, less people are able or willing to care for AYA with special healthcare needs. Most adult providers find them too complicated’ Hesitancy from pt and/ or family Lack of care coordination ‘Adult PCPs are hard to come by in general, so I think it is a systemic problem overall, not just special needs’ • Pediatric primary care Results • 19 participants, including providers from internal medicine, family medicine, and pediatrics. 2 of which were rural providers. • PCPs were most comfortable accepting AYAs with special healthcare needs with a diagnosis of a physical disability and/or an intellectual disability. • 8 providers were willing to share their contact information to be added to a registry. • Majority of providers reported they do not routinely discuss healthcare transition with their patients. • The support necessary is additional training and a list of adult specialist who will accept this population. • The biggest barrier for rural providers is lack of sub specialist involvement and the support that is needed is telehealth. • Business case provided to community partners Conclusions • Addressing barriers by providing more education, additional resources, and telehealth. • Future implementation should prioritize data collections from other regions to enhance understanding. • Pediatric primary care @uofunursing @utnurseresearch |
