BACKGROUND AND OBJECTIVES: Without adequate support, adolescents transitioning from the pediatric to the adult health care system are at increased risk for poor health outcomes. Numerous interventions attempt to improve this transition, yet few comprehensively evaluate efficacy. To advance evaluation methods and ultimately the quality of transition services, it is necessary to understand the current state of health care transition measurement. This study examines and categorizes transition measures by using the “Triple Aim” framework of experience of care, population health, and cost of care. METHODS: Ovid Medline and the Cumulative Index to Nursing and Allied Health Literature were searched for articles published between 1995 and 2013. Two reviewers independently screened studies and included those that evaluated the impact of a health care transition intervention. Measures were subsequently classified according to population health, experience of care, and costs of care. RESULTS: Of the 2282 studies initially identified, 33 met inclusion criteria. Population health measures were used in 27 studies, with disease-specific measures collected most frequently. Fifteen studies measured cost, most often service utilization. Eight studies measured experience of care, with satisfaction assessed most commonly. Only 3 studies examined all 3 domains of the “Triple Aim.” Transition interventions described in the gray literature were not reviewed. CONCLUSIONS: Transition programs are inconsistently evaluated in terms of their impact on population health, patient experience, and cost. To demonstrate improvement in the transition from pediatric to adult health care, a more robust and consistent set of measures is needed.

More than 23 years have elapsed since David Hilfiker discussed the "medical abandonment of the poor" [1]. In "Unconscious on a Corner," Dr. Hilfiker told the story of Mr. W, who received weeks of treatment at a Washington, D.C., intensive care unit. His physicians failed to diagnose his dementia during this time, giving him instructions and a treatment plan that he would never be able to follow.

In 2013, the Institute of Medicine (IOM), in collaboration with faculty and students from Georgetown University (GU), launched the first annual District of Columbia (DC) Regional Public Health Case Challenge. The idea for this case challenge was born when representatives from the IOM and GU met at Emory University's Global Health Case Competition in March 2013, and the DC Case Challenge is both inspired by and modeled on the Emory competition. The DC Case Challenge aims to promote interdisciplinary, problem-based learning in public health and to foster engagement with local universities and the local community. The case challenge engages graduate and undergraduate students from multiple schools, disciplines, and universities to come together to promote awareness of and develop innovative solutions for 21st century public health issues, grounded in a challenge faced by the local community. Each year the organizers and a student case-writing team develop a case based on a topic that is not only relevant in the DC area, but also has broader domestic and global resonance. Universities located in the Washington, DC, area are invited to pull together teams of three to six students enrolled in undergraduate or graduate degree programs. In an effort to promote public health dialogue among a variety of disciplines, each team is required to have at least three different schools, programs, or majors of study represented. Starting 2 weeks before the case challenge event, these teams are asked to employ critical analysis, thoughtful action, and interdisciplinary collaboration to innovate a solution to the problem presented in the case. On the day of the case challenge, teams present their proposed solution to a panel of judges composed of representatives from local DC organizations as well as other subject matter experts from disciplines relevant to the case. In addition to the panel of judges, content experts are recruited to volunteer their service as reviewers to assist the student case-writing team.

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