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Good 2 Go
Good 2 Go

Good 2 Go Resource Manual

The Good 2 Go Transition Resource Manual is the ideal source to learn more about the Good 2 Go program and the process of transition for youth with special health care needs from paediatric to adult health care. The manual includes a comprehensive summary of the history, philosophy, activities and success of Good 2 Go Transition Program at The Hospital for Sick Children since its onset in 2006.  This document also provides information about the importance of transitions, common barriers to successful transition programming, tools and interventions to overcome these challenges (with sample copies in the Appendix) and a reference list. While the manual is fairly comprehensive, there is a guide explaining how to use it if you are a front-line health-care provider at SickKids, a leader wanting to learn more about establishing a transition program in your organization, new to the field of transitions or a student trying to learn more about transitions.

An excerpt from the Executive Summary:

The transition of adolescents with chronic physical and medical conditions from child-centred to adult-orientated health-care system is a process that starts early, and though often as mistakenly believed, does not end with “transfer” into the adult health care system. Ideally, the preparation for transition to adult care is a “purposeful, planned movement of adolescents and young adults with chronic physical and medical conditions from child-centred to adult-orientated health care systems” (Blum, Garrell & Hodgman, 1993). Yet, the risky business of transitioning to adult health care is well-defined in the literature for youth across a variety of disease groups. Numerous position and consensus statements both nationally and internationally have called for the development of coordinated transition processes and stressed the importance of individual providers and services systems to take responsibility to ensure that patient care is not compromised during transition.  The Good 2 Go Transition Program (Good 2 Go) was founded in 2006 at The Hospital for Sick Children (SickKids) to help meet these goals.

Good 2 Go’ program goals include preparing all adolescents with chronic health conditions to graduate with the skills and knowledge needed to succeed in the adult-oriented health care system.  It was expected that this would require a significant change in the culture of SickKids that could only happen by working collaboratively with clinics and programs at the hospital and engaging adult providers in the importance of transitions. Our philosophy and vision was clear from the onset: All children and youth with special health care needs can acquire skills, while in the paediatric system, that will assist them in successfully managing their health care now and in their future. We believe paediatric health care professionals are in a position to facilitate developmental transition in a number of different ways.   

Good 2 Go aims to serve as an accessible and reliable resource within the hospital to support programs in meeting the transitional needs of their patient populations.  Our core team consists of professionals from multiple disciplines who work together to achieve program goals. Our team is currently led by a Clinical Health Psychologist and includes an Advanced Practice Nurse, Occupational Therapist and a Paediatrician. We are housed within the Division of Adolescent Medicine in the Department of Paediatrics. We practice and advocate for a Shared Management Model approach to support the development of self-management in youth with chronic health conditions.

This report includes a guide on how to use this manual, a summary of our history, synopsis and a list of resources to better understand the field of transitions. In addition, a detailed summary of our activities and resources is included and categorized into five areas: direct clinical care of patients and families, education and knowledge broker of transition needs and importance; program development support and consultation in transitions; resource and tool development; and research and evaluation initiatives.

Evaluation of transition programming is essential as the field develops and strives for the “gold-standard” of practice. We describe some of the key outcomes and indicators of transition success as categorized in the following domains: Health-related or disease-specific; Learning and acquisition of self-management skills; Biopsychosocial; and Process/Program. Many of our initiatives and projects, as outlined in this report, are underway to furthering the field of transitions and SickKids’ leadership in transition programming. We’ve listed the known and expected outcomes for our activities and next steps for further evaluation.

Over the past years, we have identified a number of challenges to successful transition and to providing exemplary transition care. These challenges include not having an identified adult health care practitioner or health care site to transfer patients; unavailability in the adult system of innovative treatments used at SickKids; incomplete transition programming in many areas and difficulty in evaluating outcomes after patients have graduated from SickKids.  Despite these challenges, there are many opportunities to further meet our goals.

Opportunities for our next few years include improved knowledge translation (training, education, resource development, certification) in line with SickKids’ strategic directions; continuing to build our program of research that can obtain infrastructure funding, including support personnel and robust alliances with adult programs; and the involvement of quality leaders to include mandatory and prospective evaluation of Good 2 Go program initiatives in all new consults. The success of Good 2 Go will persist as SickKids continues to forge clinical and research relationships with adult centred hospitals and ensures that transition remains a clinical, education and research priority status both within SickKids and SickKids Foundation.

What's New?

A lot has changed since the first version of the Resource Manual was released in 2014—from both within the field of transitions and the amazing work led within SickKids. We’ve updated the "Introduction to Health Care Transitions" to highlight some of the newest research, and added five additional "Must-Read Articles."  We’ve highlighted the impact Good 2 Go has had clinically across the hospital by ensuring our "Direct Clinical Care of Patients and Families" is acknowledge as one our (now) five service domains. All of our new initiatives—including education, consultation, program support, resources and research tools are included—over 15 more than our first edition. The improvements in the field’s understanding of the outcomes and indicators of transition success is updated. We proudly report amazing growth in our section on Good 2 Go Success—10 years and counting, across all five of our service domains. The number of research and quality improvement studies has tripled, while the amount of combined research funds supporting our transition research initiatives has grown to over $1.97 million. Finally, while our summary of the "Barriers to Successful Transitions" continues to exist and has even grown, we’ve updated the potential solutions also across areas.

In addition, whenever possible, we’ve added web links to literature, publications and our resources. We’ve updated the progress status of initiatives through the descriptions and outcomes sections.

The Good 2 Go Transition Resource Manual, Revised April 2017 (v.5) can be downloaded here, along with the supplementary documents.