Medical Student Boston University School of Medicine Boston University School of Medicine Boston, Massachusetts, United States
Background: Care coordination gaps, lack of adult provider familiarity with childhood chronic conditions, and lack of patient comfort with adult care are often cited as barriers to successful primary care transitions, especially for children and youth with special health care needs (CYSHCN).
Objective: To investigate the knowledge, attitudes, and perceived competencies of family medicine (FM) providers in regards to receiving transition-aged CYSHCN with the intent of enhancing care for a recent surge of these patients graduating from a pediatric complex care primary care clinic in Boston, Massachusetts.
Design/Methods: Family medicine providers were sent an anonymous electronic survey consisting of 13 questions. The survey asked about respondents’ perceived skills related to aspects of medical transitions using a 5-point Likert scale (1=strongly disagree, 5=strongly agree), as well as their knowledge of external resources for CYSHCN and interest in possible transition resources moving forward.
Results: The survey was sent to the 18 attending physicians and 5 nurse practitioners of the family medicine department, with 16 responses (69.6% response rate). On average, family medicine providers estimated they saw 5 patients with a physical or intellectual disability, aged 20 to 30-years-old, in the last 3 months, with a range of 0-20. Notably, 81% of respondents would feel more comfortable with this care if they had direct contact with a pediatric provider; 37% did not positively rate their communication with pediatric providers regarding transition of care plans. Seventy-five percent would feel more comfortable if they had access to care guidelines and resources for patients with SHCN. Eighty-one percent of respondents did not positively rate their understanding of changes to insurance status and how those changes impact access to care. Respondents were least familiar with Able Account/Trusts, MA Rehab Commission (MRC), and Individual Education/Service Plan (IEP/ISP)/504 Plans (Figure 1). Conclusion(s): Our findings highlight gaps in knowledge and comfort of the family medicine providers at our facility taking on CYSHCN as new patients. These are potential targets for further education, initiatives, and studies to improve the care for this population of high risk patients.
Authors/Institutions: Vanessa Torrice, Boston University School of Medicine, Boston, Massachusetts, United States; Nicole Sileo, Boston University School of Medicine, Boston, Massachusetts, United States; Jennifer Meade, Boston Medical Center, Boston, Massachusetts, United States; Melanie Fossinger, Boston Medical Center, Boston, Massachusetts, United States; Patrice Jean, Boston Medical Center, Boston, Massachusetts, United States; Soukaina Adolphe, Boston Medical Center, Boston, Massachusetts, United States; Jodi Wenger, Boston Medical Center, Boston, Massachusetts, United States
