Exploring the Pediatric-to-Adult Health Care Transition for Children with Medical Complexity

Project Summary/Abstract Children with Medical Complexity (CMC) are living longer due to advances in medical care, but they face substantial challenges when transitioning from pediatric to adult healthcare. These patients—often dependent on medical technology and continuous caregiver support—require highly coordinated, interdisciplinary care. CMC accounts for nearly one-third of pediatric healthcare resources, underscoring its clinical and systemic importance. The transition to adult care, typically occurring between ages 18 and 22, presents unique vulnerabilities. Unlike pediatric systems, which are built around team-based care, adult care settings often lack the structure and coordination necessary to meet the multifaceted needs of CMC. This fragmentation leads to increased risks for medical errors, hospitalizations, poorer health outcomes, and heightened anxiety for families. Although guidelines exist to support the transition of CMC to adult care, their implementation is often inconsistent due to systemic barriers. Furthermore, few studies have explored the specific safety hazards or resilience strategies associated with this critical transition. This project addresses these gaps by applying human factors methodologies to investigate safety risks and resilience strategies during care transition. It will also examine healthcare outcomes patterns through the transition using comprehensive chart reviews. Specifically, we aim to: 1) Identify safety hazards, resilience, and mitigation strategies used by any member of the care team during the transition of CMC from pediatric to adult settings. 2) Evaluate strengths and weaknesses in information transfer and assess the cognitive workload associated with the care transition process. 3) Assess patterns in health outcomes, patient safety events, and care utilization for CMC patients before and after the transition using retrospective chart review data.