Growing up in the health care system: transitions of care at the IWK

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In the context of health care, transition refers to the purposeful, planned movement of youth with chronic conditions from pediatric to adult-based care (Blum,2002).

Most youth with special health care needs that are treated in a pediatric setting will eventually need to be transferred to adult-based care for ongoing treatment. Transitions of care is the process that occurs over time and begins around the age of 12 to support that transfer and transition.

As Matthew Murgatroyd shares, youth transferring to adult care can expect many new experiences and changes.

Planning for adult care
by Matthew Murgatroyd

Hello there, I’m Matthew Murgatroyd, and I’m here to tell you that if you’re transitioning from pediatric into adult care, then you have nothing to worry about; in fact, this can be a very welcomed change of scenery.

Why? Here’s why!

The first thing you need to take into account when transitioning is that, yeah, it’s a new environment, and there’ll be new people and new docs who you’ve never seen before. Now I know that might sound daunting to some people, but for me, that’s a change I’ll gladly take.

I’ll admit that at first, it will be difficult to navigate my way around, and it will probably be somewhat overwhelming, but I’m sure the people there will be nice enough to give me directions. I’ll have to keep in mind that I’m going to need to remember all the medications I’m on (if any), and I’m going to need to know all the answers to the doc’s questions, so I’ll need to be on the ball game.

I think I’ll be able to learn all that stuff in time. Maybe I’ll need to bring cue-cards with me to help answer the questions…hopefully that won’t be necessary, but you never know.

Another thing I’ll need to know is how I’m going to get to all my appointments. I’d say I’ll be driving by then, and if not, then I’ll probably just take the bus. I’m also going to have to know how to schedule and cancel my own appointments. It’s actually pretty cool that I’ll have control over that.

Overall, this seems like a lot to take in at first, but I believe that it will be worth it in the end…and it’s always nice to have a little more independence.

Matthew has a great attitude towards transferring to adult care. In addition to having a good attitude and open mind, another thing that can help the transition goes as smoothly as possible is to start talking with your health care team about it in the years leading up to the actual transfer to adult care.  Working on skills to manage your own health care and to navigate the adult system can take time, so it is important to start those conversations with your health care team, including your family doctor, as early as you can.  Feeling prepared to make the move to adult care may also help decrease your worries about that move.

To support that transition for patients like Matthew, the IWK has a Transitions of Care coordinator, a Transitions of Care Committee made up of internal and external contributors including patients and families, a pediatric self-management program, You’re in Charge!, and soon, a transitions Community of Practice.

The Community of Practice welcomes health care providers and community partners involved in the transition to adult health care from across the Atlantic provinces to join. The community’s vision focuses on connecting and engaging transition champions to provide effective, sustainable and responsive care to patients and families related to the transition to adult health care.

To realize their vision, the community has three main objectives: education, collaboration and implementation.

  • Education
    • Enhance clinical skills related to the transition to adult care
    • Provide feedback on tools and resources being developed for the transition to adult care
    • Increase understanding of the impact of transition on patients and families and the importance of grounding our work in the experience and expertise of patients and families
    • Gain greater awareness of how the social determinants of health affect transition
    • Increase knowledge of adolescent health and development and the influence on transition
  • Collaboration
    • Provide opportunities to collaborate with IWK colleagues, youth and adult health care providers and community partners to enhance practice
  • Implementation
    • Provide opportunities and learning to strategize and operationalize Transition to Adult Care processes in your setting
    • Develop a plan to engage youth, families, and health care providers in the Transition to Adult Care

For more information about the Community of Practice, please contact Jackie Pidduck, transition coordinator, Children’s Health Program, IWK Health Centre at 902-470-3772 or