Identifying Patient Priority Targets for Improving a Transitional Care Young Adult Rheumatology Service: A Group Concept Mapping Evaluation

Objectives:
The study aimed to identify key priorities for improving a transitional adolescent and young adult rheumatology service through a comprehensive mixed-methods service evaluation.

Methods:
We used group concept mapping methodology. Patients (aged 16-25) attending a rheumatology adolescent and young adult (AYA) clinic completed idea generation, sorting and rating activities related to their experiences of the AYA service. Multidimensional scaling and hierarchical cluster analysis were applied to the sorted ideas to generate a concept map containing themed clusters of ideas. Rating data were analysed to identify themed clusters containing specific ideas, to determine whether these were being successfully met and to identify specific targets for future service improvements.

Results:
Forty-eight patients participated in idea generation, 10 in sorting, and 37 in rating activities. The concept map revealed six key themed clusters: Rheumatology Service Contact & Personal Information, Employment & Education Support & Advice, Mental Health & Wellbeing Support, Education & Advice About My Condition, General Clinic Improvements and Young Adult Specific Clinic Improvements. Specific improvement targets were identified within each of these themed clusters.

Conclusion:
This group concept mapping evaluation identified that the AYA rheumatology service was successfully meeting the needs of patients in many ways and helped to identify specific targets for future improvements. The resulting concept map provides a platform for use in partnership with patients to facilitate the co-design of future clinic improvements.