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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Components of transition for adolescents with special health care needs within the medical home model*

Components of transition for adolescents with special health care needs within the medical home model*
Maintain the adolescent in the home or community whenever possible
Identify the individual who will be responsible for assessing health status
Establish a plan for communication with the health care provider
Organize critical information and make it accessible
Assess the adolescent's ability to provide an accurate medical history
Shift the responsibility for information management from the parent to the adolescent or other responsible adult
Identify the collaborating team
Reassess the need for specialty and subspecialty care
Assess the family/adolescent's readiness to make the transition to adult specialist(s)
Develop a plan for the transition of care to new physicians
Develop a formal process to say "goodbye" to valued, established health care providers
Coordinate care with family, home, and community providers
Reassess the developmental appropriateness of current community services
Determine whether there are unmet needs
Assess the need for formal evaluation that will help to identify areas of strength and areas where support will be required
Coordinate subspecialty service of value to the family
Assess capacity of adolescent to assume responsibility for coordination of care
Begin to transfer responsibility to the adolescent and allow time for him or her to "practice" this responsibility
Reassign responsibility for areas of needed support
* The needs are on a continuum based upon the skills and abilities of the adolescent.
Adapted from: Kelly AM, Kratz B, Bielski M, Rinehart PM. Implementing transitions for youth with complex chronic conditions using the medical home model. Pediatrics 2002; 110:1322.
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