LBMON198 Improving Knowledge And Implementation Of Healthcare Transition (HCT) Policy And Procedure For Transgender And Gender Diverse (TGD) Youth At The UCSF Child And Adolescent Gender Center (CAGC)

Abstract

Abstract Introduction The UCSF CAGC has served TGD youth since 2009. Increased referrals coupled with an expanding young adult patient population has resulted in longer wait times and an increased need for transition to adult care services. As part of an ongoing quality improvement initiative to develop an equitable HCT program tailored to the unique needs of TGD youth at the UCSF CAGC, we developed and aimed to improve provider knowledge of a standardized policy and procedure for HCT from pediatric to adult gender care. Methods CAGC providers received training in 11/2021 on the HCT policy and procedure, including a standardized method to identify patients with whom to initiate HCT discussions. Providers completed pre- and post-training surveys evaluating knowledge and confidence regarding HCT practices. Knowledge was assessed with yes/no questions and confidence with 5-point Likert scales (1 = lowest, 5 = highest). Pre- and post-survey results were compared using proportions tests for dichotomous outcomes and Wilcoxon rank-sum tests for confidence levels. To evaluate effectiveness, baseline data on % of eligible TGD youth seen in the UCSF CAGC in 1-2/2021 with "Counseling for transition from pediatric to adult care provider" (Z71.89) added to their problem list in the electronic medical record were collected and compared to % of eligible TGD youth with Z71.89 added to their list the 4 consecutive months following the training session. Results Nine and 7 CAGC providers completed the pre- and post-training surveys, respectively. Knowledge increased in all areas although not all were statistically significant: Age limit for new patient referrals (78% to 100%, p = 0.18), upper age limit at which patients must transition to an adult provider (56% to 100%, p = 0. 04), standardized method to track patients with whom HCT discussions have been initiated (0% to 100%, p = 0. 0001), and list of criteria for assessing HCT readiness (11% to 100%, p = 0. 0004). Confidence increased in identifying patients with whom HCT has been initiated (median 2 to 4, p = 0. 02) but not in identifying patients ready to initiate the HCT process (median 4 to 4, p = 0.43). The % of eligible TGD youth seen in the UCSF CAGC with Z71.89 added to their problem list increased from 0% at baseline to 72%, 82%, 86%, and 90% in the 4 months consecutively following the training session. Conclusions Our findings indicate that standardized training led to increased provider knowledge, participation, patient identification, and implementation of HCT program policy and procedure tailored to our TGD youth population. Future initiatives will include collaboration with adult gender centers to transition TGD youth to adult care services and to evaluate the experiences of TGD youth and providers who receive them. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.