{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:26Z","timestamp":1787016986685,"version":"build-2736575974"},"reference-count":33,"publisher":"BMJ","issue":"11","funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["MCSC-1608-35861"],"award-info":[{"award-number":["MCSC-1608-35861"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Qual Saf"],"accepted":{"date-parts":[[2024,10,28]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individuals with sickle cell disease (SCD) experience poor clinical outcomes while transitioning from paediatric to adult care. Standards for SCD transition are needed. We established a Quality Improvement (QI) Collaborative that aimed to improve the quality of care for all young adults with SCD by establishing a standardised SCD transition process. This study evaluates the implementation of the Six Core Elements (6CE) of Health Care Transition, which was a fundamental component of the cluster-randomised Sickle Cell Trevor Thompson Transition Project (ST3P-UP) study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A central QI team trained 14 ST3P-UP study sites on QI methodologies, 6CE and Got Transition\u2019s process measurement tool (PMT). Site-level QI teams included a transition coordinator, clinic physicians\/staff, patients\/parents with SCD and community representatives. Sites completed the PMT every 6 months for 54 months and monthly audits of 10 randomly-selected charts to verify readiness\/self-care assessments and emergency care plans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of a possible 100, the aggregate mean (\u00b1SD) PMT score for paediatric clinics was 23.9 (\u00b113.8) at baseline, 95.9 (\u00b16.0) at 24 months and 98.9 (\u00b12.1) at 54 months. The aggregate mean PMT score for adult clinics was 15.0 (\u00b113.5) at baseline, 88.4 (\u00b111.8) at 24 months and 95.8 (\u00b16.8) at 54 months. The overall QI Collaborative PMT score improved by 402%. At baseline, readiness\/self-care assessments were current for 38% of paediatric and 20% of adult patients; emergency care plans were current for 20% of paediatric and 3% of adult patients. Paediatric clinics had one median readiness assessment shift (76%) and four median emergency care plan shifts (65%, 77%, 79%, 84%). Adult clinics experienced three median self-care assessment shifts (58%, 63%, 70%) and two median emergency care plan shifts (57%, 70%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The ST3P-UP QI Collaborative successfully embedded the 6CE of Health Care Transition into routine care and increased administration of assessments and emergency care plans for transition-aged patients with SCD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjqs-2024-017725","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T02:48:56Z","timestamp":1732243736000},"page":"747-757","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Results of a healthcare transition learning collaborative for emerging adults with sickle cell disease: the ST3P-UP study transition quality improvement collaborative"],"prefix":"10.1136","volume":"34","author":[{"given":"Ifeyinwa","family":"Osunkwo","sequence":"first","affiliation":[{"name":"Atrium Health Levine Cancer, Charlotte, North Carolina, USA"},{"name":"Novo Nordisk Rare Disease, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S","family":"Cornette","sequence":"additional","affiliation":[{"name":"Atrium Health Levine Cancer, Charlotte, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Noonan","sequence":"additional","affiliation":[{"name":"Center for Advancing Pediatric Excellence, Levine Children\u2019s Hospital, Atrium Health, Charlotte, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Courtlandt","sequence":"additional","affiliation":[{"name":"Center for Advancing Pediatric Excellence, Levine Children\u2019s Hospital, Atrium Health, Charlotte, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Mabus","sequence":"additional","affiliation":[{"name":"Center for Advancing Pediatric Excellence, Levine Children\u2019s Hospital, Atrium Health, Charlotte, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patience H","family":"White","sequence":"additional","affiliation":[{"name":"Got Transition, The National Alliance to Advance Adolescent Health, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"McManus","sequence":"additional","affiliation":[{"name":"Got Transition, The National Alliance to Advance Adolescent Health, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra M","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Sciences, Atrium Health Levine Cancer, Charlotte, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8826-5577","authenticated-orcid":false,"given":"Michelle L","family":"Wallander","sequence":"additional","affiliation":[{"name":"Atrium Health Levine Cancer, Charlotte, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R","family":"Eckman","sequence":"additional","affiliation":[{"name":"Emory University, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elna","family":"Saah","sequence":"additional","affiliation":[{"name":"Children's Healthcare of Atlanta, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4811-267X","authenticated-orcid":false,"given":"Ofelia A","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Pediatric Hematology, University of Miami School of Medicine, Miami, Florida, 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