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

As the U.S. population ages, an increasing challenge is placing hospital patients requiring long-term post-acute care into adult foster care facilities—small, long-term nursing facilities designed for individuals whose care needs exceed what can be managed at home. A key challenge in this placement process is dynamically matching hospital discharge coordinators, seeking suitable placements for patients, with facilities actively looking for residents. We designed, built, deployed, and maintain a system to support decision-making among a team of six discharge coordinators managing 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 this information to recommend suitable facilities that discharge coordinators might contact. Findings from a 14-month deployment demonstrate how timely, accurate information positively impacts matching efficacy. We conclude with lessons learned for developing information collection systems and provisioning platforms in similar contexts.