Faster Information for Effective Long-Term Discharge: A Field Study in Adult Foster Care

As the US population ages, a growing challenge is placing hospital patients who require long-term post-acute care into adult foster care facilities: small long-term nursing facilities that care for those unable to age in place because their care requirements exceed what can be delivered at home. A key challenge in patient placement is the dynamic matching process between hospital discharge coordinators looking to place patients and facilities looking for residents. We designed, built, deployed, and maintain a system to support decision making among a team of six discharge coordinators assisting in the discharge of 127 patients across 1,047 facilities in Hawai'i. Our system collects vacancy and capability data from facilities via conversational SMS and processes it to recommend facilities that discharge coordinators might contact. Findings from a 14-month deployment provide evidence for how timely, accurate information positively impacts matching efficacy. We close with lessons learned for information collection systems and provisioning platforms in similar contexts.