Safety and security of a patient admitted in the hospital is the responsibility of the hospital.
The duty sister and the security staff are responsible for keeping an eye on the patients in their ward /area and do not allow them to go outside the ward unescorted.
However, there are many situations, as mentioned below, where the patient may be found missing from his bed /room and ward unit, without the knowledge of staff on duty.
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a. Patient does not know the rules.
b. Patient is a psychiatric case, Alzheimer’s case, head injury case with temporary loss of memory or sound judgment, or in a state of emotional crisis.
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c. Patient may be a victim of a crime (e.g. kidnapping/abduction).
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d. A child wanders away from his bed/ward/parent or care giver.
e. Situations when patients will manage to sneak past the staff and the security guards and manage to disappear from the hospital unnoticed:
i. Patient wants to avoid payment
ii. Patient wants to end a forcible stay in the hospital
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iii. A child or an adolescent (13-18 years) running away from the hospital on his own.
Adult patients are normally being treated at the hospital on a voluntary basis, with their own consent, or with the consent of someone acting on their behalf in case the patient is temporarily rendered incompetent to take a sound decision.
A mentally competent adult patient has an absolute right to refuse medical care and cannot legally be prevented from leaving the facility, or forced to return to the facility after he or she has paid the hospital bill.
Whatever the reasons, a patient missing from his/her ward unit is a matter of very serious concern and must be treated with a sense of urgency because the patient’s life may be in danger. Whoever first detects the unauthorized absence of a patient, whenever, should immediately report to the ward sister and the doctor.
The first few minutes after a person is missing or abducted are critical. Quick and vigorous action may help locate the missing person or prevent an abductor from leaving the premises.
The ward sister/doctor should immediately inform the security officer, the hospital administrator and the nursing director who will immediately initiate the following actions.
i. Checking from the nearby patients/attendants for the clues, if any,
ii. Thorough search of the area within the ward/room,
iii. Initiating a missing patient alert,
iv. Information to all security personnel at all the exit points to close the exit gates accept one and start checking/searching (in case of babies) the persons moving out of the gate,
v. Search of common areas of the hospital including common toilets, hallways, corridors, terraces, garage, cafeteria, library basements, lawns,
vi. Search at the road/street outside the hospital and the nearest bus/taxi stand,
vii. Checking from the treating consultant to find out if he has any clue,
viii.Contacting the patient’s next-of-kin to find out if they know the whereabouts of the patient,
ix. Preparing a physical description of the patient:
a. Race, age, gender, complexion, height, build (slender, medium, heavy), hair color and cut, clothing description,
b. Any medical devices attached to the individual at the time the person is reported missing,
c. Last time/place the patient was seen by the staff.
x. Security will designate appropriate personnel to scan the recordings of the digital cameras covering the exit routes from the ward unit/hospital,
xi. If the missing person is not located during an initial search, informing the Police on phone and in writing,
xii. Discharging the patient in absentia, recording the time/date and circumstances of disappearance and the action taken, and informing the next-of-kin,
xiii. Getting the final bill made for subsequent payment by the next-of-kin,
xiv. Ensuring that all the relevant case papers, reports are filed in the case record,
xv. Informing the next-of-kin to come, pay the bill and receive the belongings of the patient,
xvi. Staff, visitors, and families will be questioned about the incident by security and /or other law enforcement personnel only,
xvii. The physical environment in the immediate vicinity of the incident will be left untouched and secured for law enforcement personnel. The missing infant’s family members that are in the ward unit at the time of the incident may be moved into a vacant patient room or other unoccupied space in the ward,
xviii. All of the patient’s belongings will be left in the patient’s room. After the police have inspected the room, an inventory of the patient’s belongings will be made and the belongings secured for subsequent handing over to the next-of-kin/patient or the police,
xix. All communication to the press related to the incident will be made by/with the approval of the MS,
xx. All staff on duty in the unit when an abduction occurs (even if this occurs during change of shift) will remain in the unit until law enforcement personnel release the staff members,
xxi. If the missing patient is found he/she will be taken to the Emergency Room and examined by a physician while the next-of-kin and the police are notified.