II. Definition
- Elopement
- Patient makes an intentional, unauthorized departure from a 24-hour medical facility (e.g. Emergency Department)
- Patient leaves typically without notifying facility staff of their intent to leave
- Differs from leaving Against Medical Advice
- Leaving AMA requires a patient with full Decision-Making Capacity and
- Leaving AMA requires a consent process in which patient is informed of the risks
- Wandering
- Patient with diminished cognitive capacity walks away unintentionally from a 24-hour medical facility (e.g. Nursing Home)
- Differs from Elopement in that the wandering patient is not intentionally leaving the confines of the facility
III. Precautions
- Elopement and wandering are high risk situations
- Many patients who elope have decreased Decision-Making Capacity (e.g. Delirium, Dementia)
- JCAHO considers serious adverse events (e.g. Suicide, death) following elopement to be sentinel events attributed to that facility
IV. Management
- Search for all missing patients within the facility (e.g. syncopal, incapacitated patient in a remote bathroom)
- Call the patient's home and invite them to return for continued care (document the phone call)
- Indications to contact police
- Patient is thought to be a danger to self or others
- Serious medical condition which has not been stabilized and they cannot be contacted
- Inadequate Medical Decision-Making Capacity
V. References
- Henry (2013) Avoid Being Sued, EM Bootcamp, CEME