From The Editor | October 14, 2009

Prevent Wandering Patient Tragedies

The Potential Cost Of A Medical Device Tax

On February 5 of this year, an 89-year old woman was found frozen to death outside an Illinois nursing home after wandering from her bed and out two doors. Two months earlier, an 86-year old Missouri patient was critically injured when he rolled his wheelchair down a flight of stairs, mistaking the stairwell for another room in the facility. Tragedies like these are all too common in our healthcare system, particularly in long-term care facilities. Not only do these instances of patient neglect result in loss of life, but they also expose healthcare organizations to massive liability lawsuits (e.g. the Illinois patient case was settled for $750,000) and federal health fines. It doesn't have to be this way. There are several business practices and technology solutions healthcare institutions can adopt to prevent wandering patient tragedies.

Common Sense Steps For Wandering Patient Prevention
I recently spoke with Jonathan Rosenfeld, a lawyer who represents people injured in long-term care facilities and author of the blog Nursing Homes Abuse Blog, on this topic. According to Jonathan, there are several non-technological steps a healthcare facility can take to lower their risk for a wandering patient incident. "The first step in wandering patient prevention is performing a full assessment of the patient at the time of admission to determine if they are a wandering risk and reviewing the patient's medical history," he says. "This includes confirming Alzheimer's and dementia diagnoses and speaking at length with the patient's family to get a full understanding of the patient's capabilities."

Once a patient is deemed a wandering risk, there are several common sense steps a long-term care facility can take to protect the patient from injuring himself or herself.

  1. Ensure adequate staff is dedicated to supervising patients at risk for wandering.
  2. Place wandering risk patients on the first floor of the residence rather than an upper level. This reduces the risk of them falling down stairs or a window.
  3. Invest in quality door, window, and screen locks. Make sure these locks are used in high-risk areas (e.g. stairwells, exits, etc.) and check these locks regularly to ensure they are operating properly.

RFID Provides Real-Time Patient Tracking, Security
Once a long-term care organization has taken these non-technical prevention measures, there are several technology solutions that can provide a facility with added protection against wandering patient incidents — the most basic of which are simple bed and chair alarms. A bed or chair alarm will activate when a patient is on the move, alerting staff members to check on the patient and ensure they are safe.

More sophisticated technology solutions include wireless and RFID (radio frequency identification) door security and patient tracking solutions. Basic RFID door security solutions include RFID readers, tags, and wireless keypads. With systems like these, patients are assigned an RFID bracelet when they are admitted to a facility. When these bracelets get within range of the readers placed above designated exit or danger doors, an alarm immediately sounds and the door is locked automatically. The wireless keypads included with these solutions allow staff members to bypass the system in the event they need to take a patient off premises or to another area of the facility.

Comprehensive computer-based RFID tracking solutions are also available. "These applications allow staff members to view, on any computer monitor, a full floor plan of the facility that pinpoints in near real-time where each patient is located in the facility." says Zahir Abji, president and CEO of Guard RFID Solutions, a company that provides an RFID patient tracking solution called SafeGuard. "Patient location is determined via beacons emitted every 10 seconds from each patient's RFID wristband. The facility's computerized floor plan also identifies where the building's egress points are. Most of these solutions also provide the same door alarm and automatic locking functions features that basic door security packages do, but add real-time patient visibility and tracking to the equation."

Now, you might think that RFID technology solutions like these may fall outside the budget constraints of your long-term health facility, but you might be surprised. According to Abji, Guard RFID's basic door security platform only costs about $1,100 per door. The SafeGuard solution is a bit more expensive and fluctuates based on the complexities of the facility. However, the costs of either of these systems are minimal when compared to the legal costs of a wandering patient incident or the loss of a single human life.