How Seattle Children’s Navigates Care for Young Adult Patients

To ensure Seattle Children’s maintains its capacity to fulfill its goal to care for all children, it cannot routinely provide care for adult patients (defined as 18 years and older). Additionally, it is generally in the best interest of the adult patient to be cared for in a hospital system with dedicated resources and clinical expertise based on the unique needs of adults. 

For these reasons, Seattle Children’s generally does not provide care for adult patients, but there is a policy that allows care for certain situations. The policy was recently updated, and the changes are summarized below.

Policy Overview

The primary goal of these criteria is to standardize which adults are eligible for care at Seattle Children’s. Seattle Children’s will provide care for adult patients for whom care is not available in the adult setting and/or when the pediatric setting offers significant clinical advantages. 

These criteria also provide flexibility for patient-centered transition to adult care for patients between the ages of 18 and 21 years. Established Seattle Children’s patients will continue to be cared for until transition to adult care is complete. The transition to adult care must occur by their 21^st birthday.

New patients under 21 may be seen in the ambulatory setting at the discretion of the individual specialty clinics. These patients must be transitioned to adult care by their 21^st birthday. They may be admitted for acute issues that do not require chronic, ongoing follow-up. 

New patients under 21 with chronic conditions who are not already established as Seattle Children’s patients will not be admitted at Seattle Children’s. Should these patients present to the Emergency Department, they will be stabilized and transferred to an adult hospital.

Seattle Children’s is unable to admit adults 18 years and older for mental health conditions, eating disorders or substance use disorders. Adults who are incarcerated or who are pregnant (outside of the fetal medicine program) will also be directed to an adult hospital. 

Adult patients 21 and older must meet one or more of the exception criteria below to be seen in a Seattle Children’s ambulatory clinic or admitted to the hospital. They qualify if:

• They have conditions more commonly seen in pediatric populations and for which treatment in pediatric settings is associated with outcome advantages
• They require a procedure that needs pediatric procedural expertise
• They require care for post-procedural complications related to a procedure performed at Seattle Children’s within the past 90 days
• They received a solid organ transplant at Seattle Children’s within the past year
• They are receiving care under a research protocol that can only occur at Seattle Children’s

For questions on the admission of patients to Seattle Children’s, please call the Mission Control team at 206-987-8899. For questions on ambulatory clinic criteria, please contact the appropriate clinic.