It's ironic that in December 1999, the same month that the public learned about the high medical-error rate in U.S. hospitals, one key indicator of patient safety reached its best outcome ever.
Last year, for the first time experts can recall, there were no infant abductions from U.S. hospitals.
"I was counting down to midnight on Dec. 31 saying, `Please don't page me. Please let 1999 get through without any infant abductions,' " says Cathy Nahirny, supervisor of case analysis at the National Center for Missing and Exploited Children in Alexandria, Va.
Since 1983 the NCMEC has kept statistics on how many infants are swiped each year from U.S. hospitals. From 1983 to 1999, there were 104 newborn abductions from healthcare facilities. Of those, 98 children have been found. California has had the most abductions, 29, followed by Texas, 26, and Florida, 12.
In 1998 five children were abducted from hospitals; in 1997, four.
The NCMEC has been working with hospitals around the country to improve their security and awareness of this problem.
It has developed a profile of the typical abductor: A female of child-bearing age who engages in manipulation and deception; she visits maternity units to scope out their procedures and layout before planning her abduction.
John Rabun, the center's vice president, has given site assessments to 766 hospitals and trained more than 50,000 hospital personnel. Because the cases are so difficult to solve, the NCMEC stresses prevention.
"By educating the people on the front line, we've driven potential abductors out of healthcare facilities entirely [at least for 1999]," Rabun says.
Birthing-unit personnel in turn educate parents in what protocols hospitals have set up to control access to the nursery and limit abduction risks.
At the University of Kansas Medical Center in Kansas City, for instance, "We make a very big point of educating the parents of the need," says Jon Jackson, KU's chief operating officer. "Yes, we want to make sure we know all the people who come and visit you. We keep that person outside the unit until we check with the mother, then we escort the visitor to the patient room."
The entire maternity ward is secured. Those who don't have a security key must be buzzed in. Those with access to the nursery wear special security bracelets that contain information not readily identifiable to the outsider.
There are various human and electronic identification systems throughout the hospital--some obvious, some not so obvious--that cocoon the baby as long as it's within the hospital's care.
The nursery has a backup electronic system that alerts the nurses if an infant comes too close to the perimeter of the unit. An audible tone sounds. Then, as the infant gets closer to the exit points, the doors seal and lock. An electronic override is necessary to make them open.
"We're well above the recommended standards," Jackson says. "But obviously once this happens to you as a hospital, you're very concerned that it not happen again."
An infant was kidnapped from KU on Jan. 29, 1998. Fortunately, the child was recovered within 24 hours.
But the trauma for the hospital lingered long after and led to a substantial upgrade in KU's physical facility and training.
KU handles about 1,100 births a year. The new security requirements have added about $200,000 a year in costs, Jackson estimates.
"I think it's great that we've gotten this one year with the hospitals having a zero abduction rate," Jackson says. "I hope all of us keep the focus on that. There are people out there who want to break the law. It's part of our responsibility as healthcare providers to thwart them in everything that we do."