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Patient Elopement: Widespread, but Rarely Discussed

By Jennifer Thew RN  
   December 06, 2016

New policies developed by nursing leaders at three Chicago-area hospitals guide hospital staff in caring for behavioral health patients and keeping them safe.

Caring for behavioral health patients is a major challenge for nurse leaders. When it escalates to elopement—the unauthorized departure of a patient from a hospital—patient safety becomes an immediate concern.

Patients with behavioral health needs often present to hospital emergency departments or, because of medical co-morbidities, are admitted to a medical-surgical unit where staff may not know how to care for this patient population.

But nurse leaders at Weiss and three other Tenet Health Chicago-market hospitals have worked together to develop standardized polices regarding patient elopement.

Creating policies to guide staff in caring for behavioral health patients can improve both quality and safety of care, says Mary Shehan, DNP, RN, NEA-BC, chief nursing officer at Louis A. Weiss Memorial Hospital in Chicago, part of Tenet Health.

Shehan spoke at the recent HealthLeaders Media Chief Nursing Officer Exchange at the Bacara Resort & Spa in Santa Barbara, CA.

The Problem
Patient elopement is a very real problem that most organizations have experienced at one time or another, but it is rarely discussed. About 20% of adults in the U.S. experience mental illness in a given year. About 4% experience a serious mental illness that interferes with life activities, according to the National Alliance on Mental Illness.

"Preventing patient elopement is a concern we all face, especially for those patients who are at risk for harming themselves or others," Shehan says.

Patients elope in a number of ways. Some will leave the building if they do not have constant supervision when they are sent to a have a test or procedure done, or while using the bathroom. They may also exit out an open door after another person leaves, which Shehan calls "tailgating."

No matter how elopement occurs, there are consistent, proactive ways to better prepare an organization and its staff to better deal with the issue.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.

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