Key Elements for, and Indicators of, a Successful Transition: An International Delphi Study

• A panel agreed on six essential key elements and one indicator for good transition.
• They were based on a good coordination between pediatric and adult care.
• They constitute a framework to develop guidelines to assess and compare programs.

PurposeThe purpose of this study was to reach an international consensus to determine what key elements should be part of a transition program and what indicators could be used to assess its success.MethodsFor this purpose, a Delphi study including an international panel of 37 experts was carried out. The study consisted of three rounds, with response rates ranging from 86.5% to 95%. At each round, experts were asked to assess key elements (defined as the most important elements for the task) and indicators (defined as quantifiable characteristics). At each round, panelists were contacted via e-mail explaining them the tasks to be done and giving them the Web link where to complete the questionnaire. At Round 3, each key element and indicator was assessed as essential, very important, important, accessory, or unnecessary. A 70% agreement was used as cutoff.ResultsAt Round 3, more than 70% of panelists agreed on six key elements being essential, with one of them (Assuring a good coordination between pediatric and adult professionals) reaching an almost complete consensus (97%). Additionally, 11 more obtained more than 70% agreement when combined with the Very important category. Among indicators, only one (Patient not lost to follow-up) was considered almost unanimously (91%) as essential by the panelists and seven others also reached consensus when the Very important category was included.ConclusionsUsing these results as a framework to develop guidelines at local, national, and international levels would allow better assessing and comparing transition programs.