Handing off hope: transition of care in pediatric surgery

Background: The importance of transitioning care from pediatric to adult practitioners is an often overlooked aspect of chronic disease. The benefits of a planned transition in health care are that patients will learn valuable life-long lessons on healthcare maintenance, when and how to seek medical attention for new issues that may arise, and improvements on their overall well-being. The purpose of this SAGES White Paper was to summarize the available knowledge for several pediatric surgical conditions to aid in transition of care for this patient population. Methods: The members of the SAGES Pediatric Surgery Committee elected to produce this White Paper. The group chose to focus on several important gastrointestinal diseases that may require lifelong care: tracheoesophageal fistula, duodenal atresia, anorectal malformations, childhood obesity, and gastrointestinal malignancies. For each disease process a summary of long term issues facing these patients, stakeholders involved, and follow up recommendations if required were identified. Results: Each disease process has its own unique set of long-term issues as well as multidisciplinary stakeholders and need for follow-up. However, individualized care is needed based on each patient’s unique needs. To facilitate consistent transfer of care standardization is needed for surgical diseases. Key aspects of standardization include identifying a multidisciplinary team, working towards consistent quality improvement, and implementation of policy guided processes with individual treatment plans. Conclusion: Continued work in standardizing transition of care is required for optimal treatment of this complex patient population.