Hospital issues new guidelines for elopement risk

To protect patient safety, adult patients deemed an elopement risk will wear yellow gowns, and elopement signs will be placed on these patients' room doors and nursing unit doors.

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Yale New Haven Hospital is taking steps to improve patient safety with new guidelines for adequately assessing patients for elopement risk.

Based on current literature and a successful pilot in the Medicine service line at the York Street and Saint Raphael campuses, an elopement procedure that was previously in place at the SRC has been updated for implementation at both campuses. The "Adult/Pediatric Patient Elopement Prevention and Response at YNHH" practice alert, available on the intranet under the "Policies" tab, includes specific interventions to prevent and respond to elopements. 

Elopement is defined as a patient who leaves the hospital when doing so may present an imminent threat to the patient's health or safety because of legal status or because the patient has been deemed too ill or impaired to make a reasoned decision to leave. Elopement does not include events involving competent adults with decision-making capacity who leave against medical advice or voluntarily leave without being seen. 

Practice alert highlights for patients deemed at risk for elopement based on medical staff assessment, include: 

The nurse or provider will place an order for "Flight Risk" in Epic.

• Elopement precautions will be identified in the plan of care.
• Elopement signs ("E" in a blue circle) will be placed on the patient's door and unit entry doors. Unit doors should remain closed.
• At-risk, adult patients will wear yellow hospital gowns to designate elopement risk. (Pediatric patients are exempt from yellow gowns.)
• Depending on the patient's condition, the care team may decide to use a patient sitter for patients determined to be at imminent risk (defined as one or more attempts to elope).
• Assessment will continue until the patient does not demonstrate elopement risk. The nursing narrative will reflect any changes. For patients who have eloped, there are specific steps for response. 

Next steps for patient care areas:

• Units that do not have a par for yellow gowns will call linen services as needed.
• Units should order elopement ("E") signs from the document center (form #FDC7928).

At this time, the elopement practice alert has been implemented only at Yale New Haven Hospital. A system-wide practice alert is being reviewed. For more information, contact Carolyn Haight, 203-688-5697; or Marissa Morehouse, 203-789-3890.