Dr. Kate Anderson
Co-Director
The Centre for Adolescent and Transitional Urology
The Centre is dedicated to improving care for individuals with complex medical conditions transitioning from pediatric to adult care. The adolescent transition period often leads to worsened health outcomes due to systemic gaps and limited data. Our centre focuses on innovative urological research and expert care to address these challenges and enhance health outcomes in BC.
Our Mission & Vision
Our Vision
The vision for the Centre for Adolescent and Transitional Urology is to set the standard for quality and delivery of care of patients and families as they progress from the pediatric to adult healthcare system.
Our Mission
We aim to achieve this through a specialized clinic where providers are well versed in the unique health needs of this patient population and by focusing on clinical research to advance the understanding and management of patients during this healthcare transition period.
Overview
Advances in medical and surgical care over several decades have allowed children with medical complexity to survive into adulthood. Thus, there is an increasing number of patients that require ongoing care by adult health care providers for their complex medical conditions. However, such providers lack the specialized knowledge, training, skills and resources necessary to manage the chronic health care needs of these patients as they move into the adult care model.
The current process involves a direct referral by a pediatric to adult provider when patients turn 17 years of age. The target providers that patients are referred to have either expressed interest in care for this patient population, possess the necessary specialized training, or are in the geographic vicinity of the patient. Unfortunately, the current process is not as seamless as envisioned. This poses a significant barrier to patients and caregivers who may have poor health literacy, financial hardship limiting clinic attendance, or those are simply overwhelmed with the change in care model. This patient population, in turn, has been marginalized in the current health care system.
Research
The adolescent transition period has garnered increasing interest across all fields of medicine as it is associated with an overall deterioration in health outcomes in patients with chronic health issues. Improvements in this field are limited by lack of robust data collection, and systemic lapses in the current healthcare context which exacerbate health inequities. This clinic will aim to address these issues by leveraging data collected throughout the transition clinic process and using this information to:
- Identify and better understand the current barriers to successful adolescent transition for patients with urologic conditions
- Develop a transition process for these patients that addresses the identified barriers and improve their long-term health outcomes
- Develop transitional care policy guidelines that will be scalable to other chronic pediatric surgical conditions
- Evaluate pre- and post-implementation cost-effectiveness of the transition pathway
Clinical
The clinic will be co-led by a pediatric urologist from BC Children’s Hospital (Dr. T. de los Reyes) and an adult urologist (Dr. K. Anderson) with subspecialty training in functional and neuro-urology. Given that these conditions are present in many cases from birth and continue to have sequelae into adulthood, having both pediatric urology expertise and adult urology input is essential. This collaborative approach will also provide much needed consistency for the patients during an often-tumultuous time of transition.
In addition to the collaboration between pediatric and adult providers, the clinic aims to provide a more holistic approach to care. Central to this process will be a Nurse Practitioner with a primary care focus to complement the subspecialty expertise by the urologic surgeons. This will enable patients to receive care for non-urologic issues, care-coordination amongst various providers, and anticipatory health education.
From the age of 15 to 17 years, patients will continue to be seen in the pediatric healthcare system. During this period, they will be seen annually by the transitional urology clinic provider to give the patient and family the opportunity to establish their therapeutic relationship before graduation from the pediatric system.
From the age of 17 to 25 years, the transitional clinic will be positioned to provide the following:
- Serve as another option for patients that require assessment for acute health concerns such as suspected urinary tract infections, prescription management, and arranging relevant investigations as needed.
- Provide longitudinal care, with particular focus on care coordination with different healthcare providers and specialists, co-management of common mental health conditions and concerns the patient may experience during this adjustment.
- Help patients and families navigate the adult healthcare system.
- Timely and accurate transfer of health records from the pediatric to adult health care system for care coordination
Leadership
Dr. Kate Anderson
MD, FRCSC, Co-director
Dr. Thomas de los Reyes
MD, MSc, FRCSC, Co-director