Issue link: https://viewer.e-digitaledition.com/i/425939
"You can't have a successful transition without a team approach," Peragallo- Dittko notes. "Otherwise, you're merely sending a chart to the next provider or giving a list of provider names to a patient. Our team at Winthrop-University Hospital sees transition as an endorse- ment of our capabilities to complete the continuum of care." The ca ref ully constr ucted tea m approach synchronizes everyone respon- sible for managing diabetes. "Our approach allows for open dialogue to address patients' needs," Dr. Bredefeld says. "Close collaboration with the pediat- ric endocrinology team gives me insight to the progress made in disease management thus far and clues me in to challenges patients want to address next. Given the complexities of the current healthcare environment and the rapid advancements we make in diabetes management, a team approach is critical for success." Acclimating Patients to Change Transition from pediatric to adult endo- crinology care at Winthrop-University Hospital begins long before patients or their families have to think about changing providers. "Our pediatric diabetes team begins discussions for transition when patients are approximately 10 years old," Dr. Levine says. "During this time, the pediatric team gradually decreases the amount of time parents are present in the exam room with their children. This cultivates cooperation and support of the parents and children, while encouraging independent decision- making that's part of living with a chronic disease, such as Type 1 diabetes." This ongoing process takes place over several years, so as not to jolt children or their parents or guardians with an abrupt change in medical care. "Transition is not a one-time event," Dr. Levine says. "The process promotes an environment where the child is more comfortable talking about issues, such as alcohol consumption, that might affect diabetes management. Physicians of ten act as a ba rrier to tra nsition because they hold onto the relationship with the patient and don't encourage transition. At Winthrop, our philosophy is that we want to be part of the process that helps our patients grow up and remain healthy. That process not only includes blood glucose management and skill development but also includes transitioning to adult care." A s young pat ient s g row up, t he p e d i at r ic endo c r i nolo g y t e a m at Winthrop-University Hospital encour- ages them to take increasing ownership of their diabetes management by arrang- ing their own appointments, even if their parents still accompany them to outpatient visits. When patients are old enough to attend appointments without parental supervision, providers suggest they do so. "The process is entirely tailored to the patient's needs and comfort level," Peragallo-Dittko says. "Some adoles- cents are more mature than others, and they are encouraged to take greater responsibility of their diabetes man- agement earlier, but others need more support or more time in the comfort Robert L. Levine, MD, PhD, pediatric endocrinologist at Winthrop-University Hospital, says, "At Winthrop, the philosophy is that we want to be part of the process that helps our patients grow up and remain healthy." Siham Accacha, MD, Chief of Winthrop's Pediatric Diabetes Program (seated), and Jean Corrigan, RN, MA, Program Director of Winthrop's Pediatric Diabetes Program, discuss a patient. COV ER FE AT UR E 8 | Long Island MD NEWS ■ M D N E W S . CO M