Table 2.

Recommendations and collective responsibilities for healthcare providers, and provincial, territorial, and national government systems in Canada to improve healthcare transition.

Recommendations to advocate for change in healthcare transition policy	Actions
	Healthcare providers	Provincial and territorial systems	National system
1.Flexible age of transfer (chronological age does not necessarily relate to developmental age or transition readiness).	Develop a local and/or regional policy with pediatric and adult health care providers for seamless transfer allowing for some flexibility.	Provide flexibility for the age of transfer for youth and their family who need it, which may include policy changes regarding eligibility for pediatric services and funding.	Develop national standards to assess readiness to transition, in particular for youth and families with complex healthcare needs.
2.Holistic transition to adulthood that includes the consideration of health, social and educational domains.	Build capacity in pediatric and adult care providers for holistic care and management of adolescents and young adults with childhood-onset conditions, including education about available resources. Build capacity in youth and families to empower them and develop self-advocacy skills. Promote awareness in young people and their families to optimize access resources and supports (funding, housing, education, and employment) for inclusion at the community level.	Collaborations across sectors, such as health, education and the social domain, with services working together to develop improved supports and access to those supports (including options for financial and transportation support, integrated education, accessible work environments).	Development of a federal framework designed to support an inclusive and equitable approach to transition for youth and emerging adults with healthcare needs, their families and caregivers.
3.Transition programming that begins a few years before transfer and allows time to build competencies.	Initiate conversations early with families; raise awareness of transition issues, including the barriers and facilitators, and provide reassurance to families; discuss the importance of developing self-management skills and autonomy as developmentally appropriate.	Ensure access to appropriate services and mandate early initiation of transition programming to create opportunities for youth and families to build competencies.	Promote the evaluation of transition services and share this evaluation with the public to ensure transparency; provide funding for longitudinal studies providing evidence on the long-term outcomes of holistic transition programming.