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1. Heart-Failure-Transition-Care Executive (pdf file)
   effectivehealthcare-admin.ahrq.gov/sites/default/files/related_files/heart-failure-transition-care_executive.pdf
   May 01, 2014 - authorized by the Affordable Care Act.6 This policy provides incentives for hospitals to develop effective transition … home health, outpatient followup), and symptom monitoring or reinforcement of education during the transition … No clear consensus exists about when the transition period ends. … chronic HF disease management, gaps remain in knowledge about effective interventions to support the transition … care, MDS-HF); home visits; telemonitoring (including remote clinical visits); telephone support; transition

2. Heart-Failure-Transition-Care Clinician (pdf file)
   effectivehealthcare-admin.ahrq.gov/sites/default/files/pdf/heart-failure-transition-care_clinician.pdf
   October 01, 2015 - Transitional Care Interventions To Prevent Readmissions for People With Heart Failure Focus of This Summary This is a summary of a systematic review evaluating the evidence regarding the efficacy, comparative effectiveness, and harms of transitional care interventions (defined in Table 1) that aim to reduce readmiss…

3. children-special-needs-transition-protocol-131003 (pdf file)
   effectivehealthcare-admin.ahrq.gov/sites/default/files/pdf/children-special-needs-transition_research-protocol.pdf
   October 01, 2013 - Examples of transition models include the use of a separate clinic for transition activities, a phased … the effectiveness of transition models. … Description of the context for implementing transition care a. … What are the resources needed to implement transition care? c. … Center (Got Transition?)

4. Transition Care for Children With Special Health Needs | Effective Health Care (EHC) Program
   effectivehealthcare-admin.ahrq.gov/products/children-special-needs-transition/technical-brief
   December 01, 2019 - Fewer than half receive adequate support and services for their transition to adult care. … include use of a separate transition clinic, engagement of a transition coordinator, and a phased transfer … The Got Transition resource provides a framework for transition care that can be adapted to serve the … Common components of care included use of a transition coordinator, a special clinic for young adults … in transition and provision of educational materials, sometimes using computer-based programming.

5. Transitional Care Interventions To Prevent Readmissions for People With Heart Failure | Effective Health Care (EHC) Program
   effectivehealthcare-admin.ahrq.gov/products/heart-failure-transition-care
   March 01, 2021 - https://effectivehealthcare.ahrq.gov/products/heart-failure-transition-care  

6. What is the effectiveness of interventions designed to support children in transition from pediatric care to adult care with special health care needs? Ineffective transition planning can have significant negative consequences on children… | Effective Health Care (EHC) Program
   effectivehealthcare-admin.ahrq.gov/get-involved/nominated-topics/what-is-the-effectiveness-of-interventions-designed-to-support-children-in-transition-from-pediatric-care-to-adult-care-with-special-health-care-needs-ineffective-transition-planning-can-have-significant-negative-consequence
   November 01, 2017 - Ineffective transition planning can have significant negative consequences on children… … What is the effectiveness of interventions designed to support children in transition from pediatric … For example, poor transition planning can lead to gaps in medical health care, creating more serious … Successful transition from pediatric to adult care is intended to prevent harms. … Ineffective transition planning can have significant negative consequences on children….

7. Transitions of Care for Children with Special Health Care Needs | Effective Health Care (EHC) Program
   effectivehealthcare-admin.ahrq.gov/products/children-special-needs-transition/research-protocol
   December 01, 2019 - Examples of transition models include the use of a separate clinic for transition activities, a phased … effectiveness of transition models. … What are the resources needed to implement transition care? … Center (Got Transition?) … Health care transition for youth with special health care needs.

8. Transitional Care Interventions To Prevent Readmissions for People With Heart Failure | Effective Health Care (EHC) Program
   effectivehealthcare-admin.ahrq.gov/products/heart-failure-transition-care/research
   December 01, 2019 - https://effectivehealthcare.ahrq.gov/products/heart-failure-transition-care/research  

9. Disposition of Comments Report for Technical Brief 15 Transition Care for Children With Special Health Needs (pdf file)
   effectivehealthcare-admin.ahrq.gov/sites/default/files/related_files/children-special-needs-transition_disposition-comments.pdf
   June 17, 2014 - Got Transition framework. … on transition readiness). … We have commented on use of technologies for transition in the “Transition Registry”, “Transition … Got Transition framework. … Got Transition framework.

10. Transitional Care Interventions To Prevent Readmissions for People With Heart Failure | Effective Health Care (EHC) Program
    effectivehealthcare-admin.ahrq.gov/products/heart-failure-transition-care/policymaker
    December 01, 2019 - https://effectivehealthcare.ahrq.gov/products/heart-failure-transition-care/policymaker

11. Transitional Care Interventions To Prevent Readmissions for People With Heart Failure | Effective Health Care (EHC) Program
    effectivehealthcare-admin.ahrq.gov/products/heart-failure-transition-care/clinician
    December 01, 2019 - https://effectivehealthcare.ahrq.gov/products/heart-failure-transition-care/clinician  

12. Models of Survivorship Care: Technical Brief | Effective Health Care (EHC) Program
    effectivehealthcare-admin.ahrq.gov/products/cancer-survivor-care-transition/research-protocol
    December 01, 2019 - As described in the Institute of Medicine report From Cancer Care to Cancer Survivor: Lost in Transition … and may be dissatisfied with care following cancer treatment. 9 The challenges associated with the transition … of varying provider types in medical care for survivors, including providers involved in the patient transition … From cancer care to cancer survivor: lost in transition. … https://effectivehealthcare.ahrq.gov/products/cancer-survivor-care-transition/research-protocol

13. Disposition of Comments_Comparative Effectiveness Review 255: Transitions of Care From Pediatric to Adult Services for Children With Special Healthcare Needs (pdf file)
    effectivehealthcare-admin.ahrq.gov/sites/default/files/related_files/transitions-care-pediatric-to-adult-services-disposition-comments.pdf
    May 31, 2022 - A discussion of other conceptual models for health care transition and transition interventions may … There are a plethora of studies in transition describing barriers to transition and besides the 147 … transition planning and transition of care.” … You could also use the HCT definition and goals used by Got Transition: “Health care transition, or … ,” the authors could convey that often transition was thought to be just transition preparation on

14. Models of Cancer Survivorship Care | Effective Health Care (EHC) Program
    effectivehealthcare-admin.ahrq.gov/products/cancer-survivor-care-transition/technical-brief
    December 01, 2019 - https://effectivehealthcare.ahrq.gov/products/cancer-survivor-care-transition/technical-brief

15. Transitional Care Interventions to Prevent Heart Failure Readmissions | Effective Health Care (EHC) Program
    effectivehealthcare-admin.ahrq.gov/products/heart-failure-transition-care/research-protocol
    December 01, 2019 - education, self-care) and system factors (i.e., coordination of care across settings) to support the transition … also recommend that “postdischarge systems of care, if available, should be used to facilitate the transition … Heart Failure Disease-Management Interventions and Transition of Care One difficulty in categorizing … population (excluding disease-specific interventions). 33 No clear consensus exists about when the transition … https://effectivehealthcare.ahrq.gov/products/heart-failure-transition-care/research-protocol

16. Evidence Summary_Comparative Effectiveness Review No. 255: Transitions of Care From Pediatric to Adult Services for Children With Special Healthcare Needs (pdf file)
    effectivehealthcare-admin.ahrq.gov/sites/default/files/related_files/cer-255-transitions-care-pediatric-to-adult-services-evidence-summary.pdf
    May 01, 2022 - • Transition clinics may not improve hemoglobin A1C levels at 12 or 24 months in youth with type … • No globally accepted definition exists for effective transition of care from pediatric to adult … Transition outcomes from these studies included measures ranging from transition readiness to ongoing … Health care transition for youth with special health care needs. … Transition to adulthood for youth with chronic conditions and special health care needs.

17. TND-612-09-03-2013 (pdf file)
    effectivehealthcare-admin.ahrq.gov/sites/default/files/pdf/TND-612-09-03-2013.pdf
    January 01, 2013 - 2013 1 Results of Topic Selection Process & Next Steps  The topic, Interventions to Transition … Comparator(s): Other transition interventions or no transition intervention Outcome(s): Successful … transition planning to adult care without loss or discontinuity of services, satisfaction with care … If, when and how should CSHCN transition from pediatric to adult services? 2. … Yet there was limited evidence of effective transition strategies for CSHCN and a number of unanswered

18. Transitions of Care From Pediatric to Adult Services for Children With Special Healthcare Needs | Effective Health Care (EHC) Program
    effectivehealthcare-admin.ahrq.gov/products/transitions-care-pediatric-adult/research
    October 01, 2022 - Transition clinics may not improve hemoglobin A1C levels at 12 or 24 months in youth with type 1 diabetes … No globally accepted definition exists for effective transition of care from pediatric to adult services … Low-strength evidence shows transition clinics may not improve hemoglobin A1C levels either at 12 or … No globally accepted definition for effective transition of care from pediatric to adult services for … Significant barriers impede implementation of interventions, tools, and trainings to transition CSHCN

19. Transitions of Care From Pediatric to Adult Services for Children With Special Healthcare Needs | Effective Health Care (EHC) Program
    effectivehealthcare-admin.ahrq.gov/products/transitions-care-pediatric-adult/protocol
    February 01, 2022 - This approach, called "Six Core Elements of Health Care Transition," includes: transition policy, transition … tracking and monitoring, transition readiness, transition planning, transfer of care and transfer completion … No healthcare transition intervention is explicitly excluded. … However, transition interventions that address the full spectrum of transition to adult life, such as … ediatr* or teen* or young adult* or youth)) AND (transition* N5 care OR transition* N5 plan* OR transition

20. Topic 0318 Psychiatric Hospital Discharge NSD FINAL (2)_SJ_Clean-2 (pdf file)
    effectivehealthcare-admin.ahrq.gov/sites/default/files/pdf/TND-0376-140408.pdf
    November 06, 2013 - want to know about the comparative effectiveness of different lengths of Summary: hospital stay and transition … intensive outpatient treatment including outpatient commitment, Assertive Community Treatment [ACT]) Transition … support services after discharge:  Different transition support services compared with each other …  Transition support services compared with usual care Outcome(s):  Readmission rates Topic Number … multiple psychiatric hospitalizations, what is the comparative effectiveness of different models of transition