Transition

Findings from the Real Transition Project

Results of a project conducted by Reality Check young adults with diabetes Inc. in partnership with the Royal Melbourne Hospital and with funding through the National Diabetes Improvement Project from the Australian Government Department of Health and Ageing

Reality Check, an organisation of young adults with diabetes, has been leading a 12-month Federal Government-funded project to research and implement a number of initiatives at a major teaching hospital's diabetes 'Transition Clinic'.

The project involved consulting 125 young people who attend the clinic over a 9 month period, and implementing new recommended interventions and resources to the clinic periodically.

The objectives of the project were to:

a) Develop an effective and replicable model for the transition of young people with diabetes from children’s services to adult services

b) Develop the information-seeking skills of young people with diabetes to enable more effective self-management

c) Engage and involve young people with diabetes in the improvement of the health care services that they are using

A Reference Group was formed to develop and/or pre-approve all interventions. The Group comprised:

• Associate Professor Peter Colman - Director, Dept of Diabetes and Endocrinology, Royal Melbourne Hospital
• Cheryl Steele - Senior Diabetes Nurse Educator, Royal Melbourne Hospital, also a qualified health counsellor with extensive experience as a clinical research nurse
• Kate Gilbert – Project Manager, Founder of Reality Check young adults with diabetes, and a young adult with diabetes herself
• Two young people, recruited via Reality Check, who had not sought professional medical advice for their diabetes in at least the 6 months’ prior to their joining the committee.
• Two young people, recruited via Reality Check, who currently attend the Royal Melbourne Hospital’s Transition/Young People’s Clinic.

At the conclusion of the Project in September 2004, 16 discrete activities had been developed and trialled at the clinic.

1. Text message Reminders of appointments at the clinic sent to mobile phones of patients who agreed to receive them.

2. “Welcome Sheet” published for all patients which covers: • Brief introductions to all health professionals in the clinic; • Can you see the same doctor?; • Other services at the hospital; • How to change an appointment; • Parking and Public Transport information • Who to call in an emergency. Click here to download the Welcome Sheet used at Royal Melbourne.

3. Welcome Sheet published on the adult hospital's website

4. Local Children's Hospital to provide Adult hospital's Welcome Sheet to transitioning late teens/young adults

5. Clinics cancelled at times of known events that would negatively impact attendance, such as "O Week" and "Schoolies Week".

6. Letter with test results and other issues copied to patient

7. Transitioning Out: patients to be provided with information about other clinics in different locations, and contacts and costs of local private services via an "Other Options" Fact Sheet and discussion with doctor.

8. Clinics must also cater to newly-diagnosed young adults – Reality Check’s brand new Starter Kit for Adults Diagnosed with Type 1 Diabetes is now a useful resource to have on hand

9. Showbags of new products and information provided to patients in the clinic

10. Non-Diabetes current magazines and today’s newspapers available

11. Library-style set-up of diabetes books and magazines provided for browsing plus access to photocopier

12. Food and Drinks – standing order with local café at a cost of $3/patient

13. Fact Sheets produced and provided on (click on title to download PDF file): • Alcohol • Legal Stuff • Travel • Personal Stories , and Vanessa's Pregnancy • JDRF Research Breakthroughs (from JDRF) • Pregnancy - Booklet from Reality Check, ADIPS & DAV.

For more Fact Sheets, see Reality Check's HP Resources page.

14. Living with Complications information For people diagnosed with diabetes as children, young adulthood can be a time when they begin to think about their future and worry about complications.

It has been deminstrated by psychological researchers such as Paula Trief (1998) that fewer complications, therefore shorter duration of diabetes, actually equates to more psychological impact and anxiety about complications. This project identified a need for information about living with complications if they happen, and a writer was commissioned to undertake interviews and compose an article.

Click here to Download  printer-friendly version of commissioned article. Or click here to read it online.

15. Children's Hospital Transition Seminar for late teens/young adults and their parents to focus on relevant issues such as going out, sex and family planning, travel, legal issues, new technologies and research developments, instead of solely profiling adult services

16. Diabetes Nurse Educator who is also a qualified health counsellor meets with patients who are attending the clinic for the first time and works through a prompt sheet of issues (different for male or female) which have been identified informally as common gaps in knowledge at this age.

An abstract with preliminary results of this project was accepted by the Australian Diabetes Educators Association 2004 conference. Click here to read the abstract.  

For further information about this project, please contact : Kate Gilbert Founder, President and Project manager REALITY CHECK young adults with diabetes Inc. Phone: 0402 515 825 (Melbourne) This e-mail address is being protected from spam bots, you need JavaScript enabled to view it