How to Use the Implementation Guides

The Six Core Elements of Health Care Transitionâ„¢ (HCT) offer a structured approach for

pediatric-to-adult transitional care recommended by the American Academy of Pediatrics

(AAP), the American Academy of Family Physicians (AAFP), and the American College of

Physicians (ACP) Clinical Report on HCT.

This approach incorporates a set of steps and sample tools for transition planning in pediatric care,

transfer to adult care, and integration into adult

care. Having a structured HCT process has been shown to significantly improve population

health, patient experience, and health care utilization2 and has been successfully incorporated

into many different health care settings for youth and young adults with and without chronic

physical, developmental, and behavioral health conditions.

The goal of the Six Core Elements approach is to guide systems of care and health care

professionals and clinicians in improving the ability of youth and young adults to manage their

own health and safely and effectively use health care as they transition to an adult approach to

care and/or to an adult clinician, all while partnering with youth, young adults, and their

families in the process. To implement the Six Core Elements, quality improvement (QI) methods

are recommended. The Model for Improvement, developed by the Associates in Process

Improvement, is one such framework (www.IHI.org), which is used in this implementation

guide. This guide can be used as a resource for payers, managed care organizations, health care

systems, public health professionals, and individual clinicians as they implement a structured

HCT improvement process.