Transitioning from pediatric to adult healthcare remains a critical challenge for medically complex adults with pediatric-onset conditions. Traditional models of care often fail to address the unique needs of this population, leading to gaps in care continuity, increased healthcare utilization, and poor health outcomes. This project examined the limitations of current transition models and highlighted the critical need for emergency department-level interventions, proposing an enhanced, patient-centered framework to optimize healthcare transition. Using an evidence-based approach, this project evaluated the implementation of a structured clinical pathway tailored to the needs of transitioning adults. The pathway integrated key principles of transition medicine, including interdisciplinary collaboration, shared management between pediatric and adult providers, and proactive care coordination. Outcomes measured included adherence to the clinical pathway, transition planning efforts, and patient-reported experiences. Additionally, the project assessed the impact of this model on provider confidence and institutional readiness to care for medically complex adults in a pediatric setting. Findings from this project highlighted the necessity of redefining transition care beyond a traditional pediatric framework and underscored the role of the emergency department in identifying at-risk patients and leading innovative models of care to support effective transitions. By bridging gaps in the healthcare system, this project supports the development of sustainable transition practices that improve long-term health outcomes for medically complex adults. The insights gained contribute to policy recommendations and serve as a foundation for future research to enhance transition care on a broader scale.