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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 a child-centred to adult-orientated health care system is a process that starts early, and 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 system” (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 service 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 approach model of self-management.

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 four areas: education on transition needs and importance; consultation and staff support in transition program development; resource/tool development; and research and quality improvement initiatives.

Evaluation of transition programming is essential as the field develops and strives for “gold-standard” 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 known and expected outcomes 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; lack of availability in the adult system of innovative treatments used at SickKids; incomplete transition programming in many areas and difficulty in evaluating outcomes after patients have left 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; building a program of research that can obtain infrastructure funding, including support  personnel and robust alliances with adult programs; and the possibility of 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 at The SickKids Foundation.

To review a copy of the Good 2 Go Transition Resource Manual, please contact us.