Cognitive

Patient Elopement

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Patient Elopement, Medical Elopement, Elopement Precautions

  • See Also
  1. Informed Consent
  2. Consent for Treating Minors
  3. Against Medical Advice
  4. Decision-Making Capacity
  5. CURVES Mnemonic for Capacity Assessment
  6. Competency Hearing
  7. Risk Management
  • 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
  • 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
  • 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
  • References
  1. Henry (2013) Avoid Being Sued, EM Bootcamp, CEME