Medical Summary Template for the Transfer of Patients with Inflammatory Bowel Disease from Pediatric to Adult Care

Abstract

Background The transfer of information is a key aspect of the transition of adolescent patients with inflammatory bowel disease (IBD) from pediatric to adult care. This is typically accomplished through the use of a consultation letter with a medical summary of the patient being transferred. To improve the quality and completeness of information included in a transfer letter, we developed a standardized medical summary template by integrating the feedback of adult and pediatric health care providers. Methods To develop the letter template, we purposively sampled gastroenterologists or nurse practitioners caring for patients with IBD in four Canadian cities and invited them to take part in focus group discussions. Using a semi-structured approach, we explored the items deemed essential for inclusion in a transfer summary. Using the conventional content analysis framework, the focus group discussions were inductively coded to identify areas of priority for inclusion in the template. Results Four focus groups were conducted, comprising 17 health care providers of 30 invited (56.7% participation). The resulting medical summary template included the following major headings: patient/disease characteristics, therapeutics history (including medications and surgeries), clinical history and current status, noteworthy investigations, history of complications (including hospitalizations), family history, immunization history and psychosocial history. The template also addressed health system process factors (i.e., urgency of transfer, mode of delivery and confidentiality) to ensure a seamless transfer to adult care. Conclusions The standardized medical summary template should be used by pediatric providers to ensure that essential patient information and disease characteristics are sent to an adult provider.

Proposed clinical operative synoptic report for ileocolic resection for Crohn's disease

“…A Canadian group proposed a medical summary transfer template for transition of IBD care in paediatric patients to the adult IBD team. 14 In our study, the remaining length of intestine was completely documented in less than 10% of cases. During the consensus panel's discussion, it was thought that it could be difficult to measure in the minimally invasive cases of the remaining length of small intestine.…”

“…A proportion of patients are diagnosed with CD during their teenage years and the incidence is expected to increase. A Canadian group proposed a medical summary transfer template for transition of IBD care in paediatric patients to the adult IBD team 14 . In our study, the remaining length of intestine was completely documented in less than 10% of cases.…”

Canadian Consensus Statements on the Transition of Adolescents and Young Adults with Inflammatory Bowel Disease from Pediatric to Adult Care: A Collaborative Initiative Between the Canadian IBD Transition Network and Crohn’s and Colitis Canada

“…Canadian pediatric and adult IBD experts involved in transition have conducted qualitative evaluations on pertinent contents for care transfer ( 82 ). The transfer package may include a concise summary letter, copies of important consultative and investigative reports.…”

Supported COVID‐19 Vaccination Pathways for Adolescents and Young Adults With Significant Challenging Behaviours and Developmental Disability

“…Indeed, transition programmes are an important tool to increase patients' adherence to care, and eventually improve overall outcomes. 2 As approximately 25% of patients with IBD are diagnosed before 18 years of age, we feel that a global and thorough implementation of transition programmes from paediatrics to adult care for adolescent patients with IBD should be pursued in every IBD centre so as to improve their management. 3,4 Assessing sound outcomes, as in the study by Mollah et al, is essential to establish the efficacy of these programmes in clinical practice.…”

“…This is despite the fact that there is emerging evidence that younger people with DDs and comorbidities are at higher risk of COVID-19. 2 Therefore, there are calls for prioritising vaccination for this vulnerable group of people. 3 We share our experience of supporting 24 adolescents and young adults with COVID-19 vaccination during the unprecedented times of the COVID-19 pandemic restrictions.…”