D.JOY Strengthens Support for Introducing Its Leave-Alert System to Help Hospitals Meet Physical Restraint Minimization Requirements

D.JOY Inc. announced that it will strengthen support for medical institutions introducing its “Leave Alert” system, which uses beacon technology to detect in real time when inpatients leave the hospital or ward without authorization. The initiative is designed to help hospitals respond to requirements for minimizing physical restraints, which became mandatory under Japan’s FY2024 medical fee revision and were further strengthened in the FY2026 revision scheduled to take effect this June. In response to urgent concerns from clinical sites that “patients may be in danger unless they are restrained,” Leave Alert offers a mechanism of “watchful support, not surveillance.” By attaching transmitters to patients and installing receivers, a warning lamp is activated the moment a patient leaves the ward without authorization. The system helps protect patient safety even at night, when staffing is limited, or in locations outside staff members’ direct line of sight. At Shonan Kamakura General Hospital, the number of reported unauthorized hospital or ward departures decreased in wards where Leave Alert was introduced. Staff commented that although there had previously been situations where they had no choice but to rely on restraints, the system has made it easier to protect patient safety while also considering patient freedom and prevention of ADL decline. Japan’s June 2024 medical fee revision added “minimization of physical restraints” to the facility standards for basic hospitalization fees, making it mandatory across all wards, from acute and chronic care to ICUs and emergency wards. Medical institutions that fail to meet the standards face a penalty of a 40-point daily reduction in hospitalization fees after the end of transitional measures in June 2025. The FY2026 revision further strengthens this framework by dividing the standards into two stages: standards related to institutional systems, such as team formation and policy development, and standards related to outcomes. Institutions lacking the required system will face a 40-point daily reduction, while those with systems in place but failing to meet outcome-related standards will face a 20-point daily reduction. At the same time, a new 40-point daily add-on, the Physical Restraint Minimization Promotion System Add-on, will be introduced for institutions carrying out particularly high-quality initiatives, making differences in efforts more directly tied to medical reimbursement. Dementia care add-ons will also be affected: on days when physical restraints are used, the add-on will be calculated at only 20% of the designated points, effectively an 80% reduction. In addition, facility standards now allow wards that introduce ICT devices in three areas, monitoring, recordkeeping, and information sharing, to continue calculating basic hospitalization fees even if the number of nurses assigned decreases by up to 10%. Leave Alert can be used as an IoT device that meets the Ministry of Health, Labour and Welfare’s monitoring requirements and supports fulfillment of facility standards. The system is clearly shifting from an “effort obligation” to outcome-based evaluation. Clinical sites are now expected not only to establish systems but also to achieve a concrete numerical target of keeping restraint rates at 15% or lower. However, hospitals continue to face concerns about whether patients with dementia or delirium can be kept safe without restraints, whether night shifts with limited staff can constantly track patient movement, and whether delayed discovery of unauthorized departures could lead to serious incidents. As hospitals are required to reduce physical restraints while maintaining responsibility for patient safety, interest in Leave Alert is rapidly growing as a technological solution to this dilemma. As Japan’s population ages, the importance of monitoring patients with dementia and preventing unauthorized departures is increasing. The Ministry of Health, Labour and Welfare estimates that the number of older people with dementia will reach 4.716 million in 2025 and 5.842 million in 2040, and medical safety professionals have pointed to a rise in unauthorized patient departures. Unauthorized hospital or ward departures create not only patient safety risks but also major burdens on ward operations. If a patient at risk of leaving heads toward an elevator hall, nurses must accompany the patient, interrupting nurse call response and care for other patients. If the patient is lost from sight, multiple staff members must search floors, stairwells, and elevators, weakening safety management for other patients. If the patient leaves the hospital, staff may need to check security camera footage, contact family members, notify police, and later prepare incident reports and recurrence-prevention measures. There have also been media reports of hospitals facing claims for damages due to alleged breaches of management obligations. Leave Alert is an unauthorized departure prevention system that uses BLE beacon technology. A transmitter is attached to a patient identification band, and receivers are installed at ward exits, elevator halls, emergency stairways, and other locations. When a patient leaves the ward without authorization, a warning lamp at the staff station is activated, allowing staff to confirm the patient’s location in real time. The system is designed to help staff notice and act early while the patient is still inside the hospital, rather than searching only after the patient has disappeared. Key features include easy transmitter attachment with minimal patient burden; compact design that can be attached directly to existing patient ID bands; lightweight, soft, waterproof materials that reduce skin trouble risk; support for registering patient names and IDs; reuse for multiple patients within the usage period; and an approximately six-month transmitter life. The system also provides dual notifications through warning lamps and smartphones. When a receiver detects a patient passing through, the warning lamp at the staff station lights up and push notifications are sent to staff smartphones, enabling multiple professions to share the situation even when away from the station. The lamp color can be customized in red, blue, or yellow according to detection location and site operations. Passage histories through hospital receivers can also be checked if a patient is lost from sight, greatly reducing search time. The BLE standard used by Leave Alert has an extremely low risk of interfering with pacemakers and is already used by many university hospitals. At Shonan Kamakura General Hospital, incidents had occurred in which patients with higher brain dysfunction, dementia, alcohol dependence, and other backgrounds left without authorization via elevators or emergency stairs. In some cases, significant time had already passed by the time the departure was discovered, requiring searches outside the hospital building and contact with police. The hospital introduced the system in neurosurgery, EHCU, and gastroenterology wards. Warning lamps enabled immediate recognition of ward departures, and reports of unauthorized hospital and ward departures decreased. In FY2024, 28 departures occurred in wards where the system had been introduced, but all were detected and handled early, preventing serious incidents. The hospital flexibly attaches transmitters to patients judged by nurses at admission to be at risk of leaving, including attaching them to ankles when patients are bothered by wrist placement. It also differentiates warning lamp colors, using blue for entrance or exit detection and red for detection outside the ward, to prevent staff from becoming desensitized to alerts. Eiichi Nakajo, Executive Officer of D.JOY’s Labor Support Business Division, said that the further strengthened FY2026 medical fee revision has made minimization of physical restraints an obligation for medical institutions. More important than regulatory compliance, however, is returning to the essence of medicine: protecting patient dignity. To minimize physical restraints, clinical teams need a concrete answer to the question of how to ensure safety without restraints. Leave Alert is a mechanism for shifting from operations in which nurses continue chasing patients to operations in which teams notice early and act quickly. D.JOY will continue supporting ward DX that enables nursing departments, medical safety managers, and information systems departments to work together to balance patient safety and dignity. D.JOY stated that it will continue providing solutions that reduce the workload of medical sites and improve medical services under its philosophy of giving every healthcare professional the next move.