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Five ways to safeguard your patients' valuables

Healthcare Security and Emergency Management, September 1, 2004

Improperly safeguarding patient property may be perceived as careless and lead to the assumption that staff are equally as careless in their medical care. Security departments should make sure their hospitals have clear policies and procedures that spell out how to handle valuables during a patient's stay.

HSEM spoke with four industry insiders about this issue. They recommend that policies and procedures regarding patients' property include the following five measures.

1. Encourage patients to leave valuables at home.

When a patient first makes arrangements for his or her hospital stay, the admitting office and other involved parties should make it clear that he or she should leave all valuables at home, explains Steven Dettman, CHPA, director of security and visitor support at the Mayo Clinic and Hospital in Scottsdale, AZ. If he or she still brings items to the hospital, arrangements should be made for a relative or friend to take them home.

"These statements should be right in the hospital's admission paperwork so the patient understands the hospital's policy up front," Dettman advises. Staff should also reiterate the policy verbally to make sure the patient didn't overlook the language in the paperwork.

2. Require patients to sign a liability waiver.

If patients arrive at the hospital with valuables and are unable, for whatever reason, to send them home, require them to sign a waiver of liability as part of the admissions process, recommends Don Walker, director of security at Sentara Norfolk (VA) General Hospital, to relieve the hospital from responsibility for any lost or stolen property, he explains.

3. Offer patients a place to lock away valuables.

If possible, make a safe or lockbox available for holding patients' belongings. "[The safe] could be located in the admitting office or the security office," says Linda Glasson, security manager at Obici Hospital in Suffolk, VA.

"Storage and lockup capabilities differ from institution to institution," she says, "but whatever they may be, make sure the patient understands up front what your policy is and where [his or her] items will be kept."

For example, Sentara Norfolk General Hospital requires its patients to put small valuables (e.g., watches, money, glasses, etc.) in an envelope, sign a waiver, and keep the envelope on their person for the duration of their stay, Walker explains.

Large or electronic items, such as laptop computers and personal digital assistants, are locked in a safe located in the security office.

4. Use an inventory and receipt system.

When patients request the safekeeping of their belongings, have them place the items into a tear-resistant envelope and record the inventory on a form that clearly displays the patient's name and date and time that inventory was taken. Also have space for the signatures of two witnesses, preferably hospital staff, advises Fred Roll, MA, CHPA-F, CPP, president of Roll Enterprises, Inc., in Morrison, CO.

"Describe the belongings in objective terms, being careful not to write down simply what a patient may tell you about an item," he says. For example, a watch may be gold-colored, but not necessarily made of actual gold. "And don't simply put down 'watch.' If it's a Seiko, write down 'Seiko.' "

If you put money in an envelope, note the bill and coin denominations. These measures ensure accurate inventory control.

Consider using a numbering system to avoid confusion among patients with similar names, Roll adds.

Ideally, the inventory forms should be made in triplicate. That way, the security, admitting, or business office can keep a copy for its records, the patient can take one as a receipt, and the third copy can be placed in the item envelope as backup.

"Items should be inventoried regularly," says Dettman. "Compare the items listed on the form to what's actually in the envelope." Individuals who take the inventories should initial and date the form to document their efforts.

When a patient is discharged, he or she turns in the receipt in exchange for the envelope. If a patient is unable to pick up his or her items, a designated family member or friend may do so instead.

"When patients originally fill out the inventory form, have [them] write down the names of one or two individuals who have their permission to pick up items for them," suggests Walker.

Hospitals should require all designees to show at least one form of positive identification (e.g., a valid driver's license)-in addition to the receipt-when retrieving belongings for a patient.

Always make sure the patient or designee opens and empties the envelope before leaving the security office (or wherever items are held), Roll recommends. Have him or her double-check all of the items in the presence of a staff member and sign out. If money is in the envelope, have the person count it out for the staff member.

5. Don't forget the emergency department (ED) and outpatients.

Policies and procedures should make provisions for safeguarding the property of hospital outpatients and ED visitors.

"Patients brought to the ED are often alone and are rarely admitted to the hospital, so we give them special green envelopes to put their belongings in," says Walker.

These envelopes stay in a secured location at the ED main desk. They also include a form that serves as an inventory record for the ED staff and a receipt for the patient.

The Mayo Clinic and Hospital has a dedicated locker room where outpatients can store their belongings.

"Outpatients have total control and responsibility over their locker keys," Dettman explains. But he acknowledges that providing lockers would be challenging for hospitals with large outpatient populations. "They would have to apply a modified version of the inventory and receipt system," he says.

Dettman predicts that, in the future, many hospitals will follow the hospitality industry's example and provide lockers or safes in patient rooms.

"I've heard of new hospitals being designed this way," he says, "but for now, most of us need to stick to clear policies and procedures."

 

Sample patient valuable policy

Procedure

I. General information

A. All patients will be instructed to send valuables home with family/other.

B. If a patient refuses to send valuables home or deposit them in the hospital safe, he or she will be asked to sign a release form.

C. Valuables envelopes: Envelopes are dispensed from central registration. Envelope numbers will be logged into the book in admitting.

D. Acceptable/unacceptable valuables: Acceptable valuables are considered to be articles such as jewelry, money, credit cards, wallets, and keys. Valuables not accepted are articles such as knives, guns, drugs, dentures, eye glasses, smoking materials, medications, and combs. If any weapons or drugs are brought in, contact security at _________.

E. Unusual/large items: Contact security at ________ for any unusual, large, or electronic item, such as a briefcase, pager, cell phone, lap top, etc.

F. Itemize all receipts as follows: 1 Set of keys, 1 Exxon credit card, 1 driver's license. All cash must be totaled and amount written in designated area. All items of jewelry must be described (i.e., 1 gold-colored watch, 1 ring with clear stone, etc.)

G. Envelope receipts: One receipt is given to the patient and placed in the chart at admitting.

H. Transporting valuables to admitting*

1. Emergency department (ED)-At the end of each shift, the valuables envelopes of admitted patients are to be taken to admitting.

2. Nursing units-From 7:00 a.m. to 9:00 p.m., call ________. Someone from admitting will respond within one hour to collect the envelope(s). From 9:00 p.m. to 7:00 a.m., call security at________**. A security officer will respond within one hour.

* Valuables will not be accepted if an envelope is not completed.
** Document the time the call was made on the envelope. The responding individual (i.e., security officer) will document the time of the pick up.

Release

Valuables are released to patients upon discharge or as requested. Valuables may be released to a designated representative upon receipt of the signed waiver from the patient and a copy of the individual's identification card.

Follow these steps to release valuables:

1. Withdrawal of part of the listed contents is prohibited. If a patient wishes to retrieve specific items, the remaining items are to be placed in a new envelope.

2. Valuables log book is checked to verify that valuables have been received.

3. The patient or designated representative must present a receipt before valuables are released. If the patient does not have a receipt, obtain a copy from the medical record. If no copy is available, valuables may be released after positive identification is made using the patient identification bracelet or picture ID card.

4. The designated staff member and the security officer will open the safe in the presence of the patient or designated representative.

5. The envelope will be opened by the patient or his or her representative in the presence of the security officer and admitting representative. The contents will be verified, and the individual will sign the envelope.

6. All appropriate information is recorded in the valuables log.

7. The valuables log is signed by the individual accepting the valuables and the admitting representative.

8. The signed receipt is placed in the designated file in Admitting and retained for one year.

9. Any time valuables cannot be located or the patient states that valuables are missing, security is to be notified immediately.

II. Specific information

A. ED

1. All valuables are placed in the valuables envelope only.

2. Receipt is itemized.

3. Envelope is sealed in the presence of the patient.

4. If the patient is unconscious or otherwise unable to sign the receipt, it must be signed by two staff members who witnessed the placement of valuables in the envelope (name-printed and written).

5. The envelope is placed in the designated area of ED registration. At the end of each shift, envelopes of admitted patients are taken to the Admitting office by a registration staff member.

6. Envelopes of patients treated and released are returned to patients at discharge (see "releasing valuables").

B. Nursing/clinical areas

1. All valuables are placed in the valuables envelope only.

2. Receipt is itemized

3. The envelope is sealed in the presence of the patient.

4. If the patient is unable to sign the receipt for any reason, it must be signed by two staff members who witnessed the placement of valuables in the envelope (name-printed and written).

5. A receipt is given to the patient and the second receipt is placed in the chart.

6. A call is placed to either admitting or security for valuables pick up (see transporting valuables).

7. Valuables may be kept on the nursing unit or in a clinical area for a short time. This would be done if

  • valuables are going to be returned within a few hours

  • a locked drawer or area is available

    8. When returning valuables, follow release guidelines found in this procedure.

    C. Admitting/central registration

    1. Patient present

    A. All valuables are placed in the valuables envelope only.

    B. Receipt is itemized.

    C. Envelope is sealed in front of the patient.

    D. Appropriate information is written in the valuables log.

    E. Valuables are placed in the safe.

    F. One receipt given to patient and the second is attached to the patient's paperwork.

    2. Patient not present

    A. Envelope is stamped and signed.

    B. Log book is completed and signed.

    C. Valuables are placed in the safe.

    3. Additional admitting responsibilities

  • Central registration/admitting team coordinator will do a monthly audit of contents of the valuables safe.

  • If it is found that valuables have been left after discharge, every effort will be made to contact the patient by phone/mail. If after three attempts the individual cannot be contacted, the valuables will be taken to the cashier office and placed in the large safe. This is to be documented in the log book.

  • Annually unclaimed valuables are sent to the [State capital building-include address].