ABSTRACT:
Patients who abscond from Free State public Healthcare facilities; 2020 - 2023

BACKGROUND:
abscondment refers to the unauthorized departure of a patient from a healthcare facility. this can occur during admission, from the ward, or at discharge, before the finalization of processes. Such incidents are classified as patient safety incidents (P.S.I), with high risk of harm to the patient and, in some cases, the community. therefore, they are categorized as severity assessment code 1.

METHODS:
the study comprised two qualitative arms: a retrospective record review and an online survey. data were extracted from the P.S.I system of the free state department of health for the period january 2020 to december 2023. an online descriptive survey was conducted among all hospital quality Aassurance Ccoordinators, nursing managers, clinical managers, and others to assess potential health system, staff, and patient risk factors associated with absconding.

RESULTS:
the study yielded several significant findings. the highest rates of abscondment were recorded in mangaung, with a predominance of male patients. the majority of abscondments occurred in wards and were classified as no harm, near miss, or harmful. primary factors contributing to abscondment were patient-related, followed by a combination of patient and organisational factors. patient outcomes varied, with a substantial portion experiencing no harm, while others faced mild to severe consequences. organisational outcomes included increased resource allocation and the need for additional staff. the root cause analysis identified communication gaps and inadequate security measures as major contributing factors.

CONCLUSIONS:
the study highlighted critical issues related to patient management and organisational practices. additionally, targeted interventions are to address the specific needs of male patients and those at higher risk of abscondment, to improve patient safety and reduce the incidence of abscondment.