II. Definition

  1. Elopement
    1. Patient makes an intentional, unauthorized departure from a 24-hour medical facility (e.g. Emergency Department)
    2. Patient leaves typically without notifying facility staff of their intent to leave
    3. Differs from leaving Against Medical Advice
      1. Leaving AMA requires a patient with full Decision-Making Capacity and
      2. Leaving AMA requires a consent process in which patient is informed of the risks
  2. Wandering
    1. Patient with diminished cognitive capacity walks away unintentionally from a 24-hour medical facility (e.g. Nursing Home)
    2. Differs from Elopement in that the wandering patient is not intentionally leaving the confines of the facility

III. Precautions

  1. Elopement and wandering are high risk situations
  2. Many patients who elope have decreased Decision-Making Capacity (e.g. Delirium, Dementia)
  3. JCAHO considers serious adverse events (e.g. Suicide, death) following elopement to be sentinel events attributed to that facility

IV. Management

  1. Search for all missing patients within the facility (e.g. syncopal, incapacitated patient in a remote bathroom)
  2. Call the patient's home and invite them to return for continued care (document the phone call)
  3. Indications to contact police
    1. Patient is thought to be a danger to self or others
    2. Serious medical condition which has not been stabilized and they cannot be contacted
    3. Inadequate Medical Decision-Making Capacity

V. References

  1. Henry (2013) Avoid Being Sued, EM Bootcamp, CEME

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Ontology: Elopement precautions (C0262691)

Definition (NIC) Minimizing the risk of a patient leaving a treatment setting without authorization when departure presents a threat to the safety of patient or others
Definition (ALT) Taking precautions to prevent and/or minimize a patient's risk of wandering. Service is billed in 15-minute increments.
Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 386278005
English Elopement Precautions, elopement prkxns, Wandering prevention each 15 minutes, Elopement precautions, Absconding precautions, Elopement precautions (procedure)
Spanish precauciones para evitar la fuga del paciente (procedimiento), precauciones para evitar la fuga del paciente

Ontology: Patient Elopement (C3178742)

Definition (MSH) Termination of hospitalization by PATIENTS against advice of healthcare provider and unknown to the provider or institution.
Concepts Individual Behavior (T055)
MSH D016312
English Elopements, Patient, Patient Elopements, Patient Elopement, Elopement, Patient