How to best support medical patients without homes

By Kevin Manne

BUFFALO, N.Y. — After unhoused people leave the hospital, they achieve the best outcomes when leaders and frontline staff at health and social service agencies work together to provide care, according to new research from the University at Buffalo School of Management.

Available online ahead of publication in the Journal of Interprofessional Care, the study examines how medical respite programs (short-term care for people experiencing homelessness post-hospitalization) facilitate collaboration to deliver the best care for these patients.

“Respite programs vary widely since no federal standard exists,” says study co-author Sanjukta Das Smith, PhD, associate professor of management science and systems in the UB School of Management. “Through our study, we found that the most effective systems have partnerships that are built on strong relationships between administrators and frontline staff, and that regular, structured meetings are the glue that holds those relationships together.”

To measure how these groups work together, the researchers studied 15 organizations in a Buffalo medical respite program, collecting data from 20 administrators and more than 40 frontline care coordinators through interviews and surveys on collaboration frequency, communication, relationships, coordinating mechanisms and role attributes. They then used social network analysis to map connections and relational coordination scoring to measure teamwork quality, comparing results between administrative and frontline groups.

Their findings show that to best serve their unhoused patients, medical respite programs and other transitional care initiatives should develop consistent meeting structures, integrate frontline staff more fully into collaborative processes and consider the distinct roles administrators and care coordinators play in connecting organizations.

“By establishing teams that bring together administrators and frontline workers, these teams can improve the way care is coordinated for people experiencing homelessness,” says Smith. “Structured, recurring touchpoints are key to building and sustaining the relationships that make this work possible.”

Smith collaborated on the study with Amanda Joy Anderson, PhD, postdoctoral fellow with the U.S. Department of Veterans Affairs and adjunct instructor in the UB School of Nursing; Suzanne S. Dickerson, PhD, professor and associate dean for doctoral research, UB School of Nursing; Sharon Hewner, PhD, professor, UB School of Nursing; and Katia Noyes, PhD, professor and director of the Surgical Outcomes and Research Center, UB School of Public Health and Health Professions.