Authors
Sarah Malecki, Chioma Nwebube, Julia Orkin, Ilana Halperin, Naba Khan, Tomisin John, Hans Katzberg, Amanda Steiman, Rano Matta, Tarek Abdelhalim, Danielle M Andrade, Natasha Bollegala, Shaelynne Bush, Clodagh Ryan, Kimberly Colapinto, Eleni Dimaraki, Hanna Faghfoury, Jennifer Fu, Natasha Gakhal, Kate Gent, Chana Korenblum, Perla Lansang, Iliana C Lega, Mary Jane Lim-Fat, Jessica Liu, Susan Miranda, Geetha Mukerji, Christian Pagnoux, Eryn Vandepoele, Ophir Vinik, Karla Wentzel, Darryl Yates, Eyal Cohen, Alene Toulany
Published in
BMJ open quality. Volume 15. Issue 3. Aug 26, 2026. Epub Aug 26, 2026.
Abstract
Transition from paediatric to adult healthcare is particularly challenging for youth and their caregivers with complex health conditions, in part due to loss of paediatric supports and fragmentation of care, contributing to adverse outcomes. To date, transition research and policy has been largely driven by paediatric providers. Adult provider insights are critical to inform gaps in care, transition planning and enable innovative and sustainable interventions.
To describe adult subspecialist perspectives on barriers, facilitators and opportunities to improve the transition from paediatric to adult care for youth with complex health conditions.
An adult subspecialty advisory panel was convened as part of a quality improvement initiative, with physicians from the University of Toronto's Department of Medicine who participated in three virtual meetings through nomination and stakeholder mapping. The first meeting focused on identifying current challenges and opportunities in transition to adult care; the second generated recommendations based on experiential knowledge and the third reviewed case studies to identify gaps and potential solutions. Discussions were recorded, transcribed and analysed using thematic qualitative analysis.
Adult subspecialists identified five key areas for improvement: (1) preparing patients and families for the realities of adult care; (2) bridging communication gaps between paediatric and adult systems; (3) moving beyond age-based transition toward flexible, readiness-informed care; (4) strengthening collaboration among adult providers caring for young adults; and (5) addressing structural and infrastructure barriers within adult care systems.
Adult care physicians expressed and validated that young adults have unique care needs during their transition to adult care. They highlighted the need for stronger cross-system collaboration, resources and investment to ensure effective transition. These findings highlight barriers in implementing current paediatric-led transition standards and provide a foundation for system-level, disease-agnostic approaches to improve continuity of care across the paediatric-adult divide.
PMID:
42648749
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.
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