P2.098: Facilitating the transition to adult medicine for admitted medically complex pediatric patients

Purpose/Objectives: Medically complex, technology dependent children represent a growing pediatric patient population. As these patients age to adulthood, ensuring a continuum of outpatient care remains paramount to improved patient outcomes, reduced hospital admissions, and mitigating healthcare costs. Without access to durable medical equipment and insurance, adult admissions to the pediatric critical care unit (PICU) become more frequent and more expensive, costing as much as 500% more per admission at Texas Children’s Hospital, The Woodlands. Though referrals to the Baylor Adult Medicine Transition Clinic can be made by families or pediatric primary care providers, no process currently exists for inpatient teams to make or facilitate referrals. By creating and distributing a transition packet at time of discharge from Texas Children’s Hospital, The Woodlands PICU, we aim to increase the number of patient referrals to the Baylor Adult Medicine Transition Clinic by 10% before October 2025.

Design/Methods: Patients admitted to Texas Children’s Hospital, The Woodlands PICU aged 17 years and older with medical complexity and developmental delays were included beginning October 2024. At time of discharge, a transition packet with referral information for the Baylor Adult Transition Clinic was provided to families in the after-visit summary. Additionally, referral information was distributed by inbox messaging to the patient’s current primary care provider. Process measures monitored included the number of patients who received the transition packet. Outcome measures included the number of patients referred through retrospective chart review.

Results: Within three months of our first PDSA cycle, 13 patients have met inclusion criteria. 100% of patients (13/13) received the transition packet at time of discharge from PICU. 38% (5/13) were referred to the Baylor Adult Medicine Transition Clinic and 23% (3/13) were evaluated in clinic.

Conclusion/Discussion: Distribution of a transition packet at time of discharge from the PICU can facilitate the transition process for medically complex patients from pediatric to adult medicine. By ensuring an age-appropriate medical home, we anticipate improved patient outcomes and significant healthcare cost savings.