February 2003
Volume 27 No. 2

New policy details procedure for missing patients

Stanford Hospital has established a new policy detailing the procedures to be followed when a patient leaves a nursing unit without notifying staff and remains missing for more than 45 minutes. The new policy, on what is known as elopement, was adopted to clarify the roles of physicians and staff in such situations and to establish a standardized response for all hospital units. To prevent cases of elopement, the policy states that all units should maintain a sign-out or notification system and that staff should tell patients upon admission that they must notify staff if they wish to temporarily leave the unit.

For patients who are not deemed competent - including disoriented patients and those with psychiatric disorders - elopement is considered to have occurred as soon as the patient is discovered missing. For competent patients, elopement is considered to have occurred if more than 45 minutes have elapsed since the patient was last seen on the unit.

According to the policy, the attending physician should be paged once a patient is deemed to be missing. The physician's role is to communicate with the patient's family and assess the patient once he/she is returned to the unit. If the patient is not found within four hours, he/she is discharged from the system and must be readmitted upon returning to the hospital.

The elopement policy, which is similar to those at other medical centers, was developed after a recent event "made it clear we needed to have a standard response," said Debra Gerardi, SHC patient safety manager. She noted that elopement is different from leaving "against medical advice," in which a patient asks to leave the hospital and then does so against a physician's advice. SHC has a separate, pre-existing policy for such situations.

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