EP 61 - Implementing Equitable and Efficient Measles Entry Screening to Reduce Exposure Risk

Background: Measles is highly contagious and poses significant risk to patients when not mitigated appropriately. When a patient with measles enters a healthcare facility, all others in that area are considered exposed. Transmission may occur up to two hours after a patient has left a space, and up to 90% of susceptible people who are exposed to the virus will develop measles. This poses a threat for community spread. Our objective is to create an equitable screening process for measles exposure and symptoms prior to facility entry without requiring extra staff.

Methods: Due to a measles outbreak in 2019, we posted signs to screen patients for measles. The signs were written in English and asked patients to self-screen for relevant symptoms and travel. We implemented Plan-Do-Study-Act (PDSA) cycles to review screening signs to ensure they effectively and equitably communicated the need for patients and others entering our facilities to self-screen for measles exposure risk.

Results: PDSA cycles resulted in three iterations of signs over time as our organization attempted to strengthen our measles response and incorporate equity and inclusion principles. The final sign included content in English with QR codes to information translated into the top four languages other than English. This version featured content including measles symptoms, space to include locations where an exposure had occurred, and instructions on what to do if someone screened positive. Signs were placed at each building entry point during measles outbreaks with plans to respond to positive self-screenings.

Conclusions: We provide a replicable framework for screening potential measles patients before entering a healthcare facility. The sign and processes supporting it are equitable, accessible, and sustainable. The plan offers an efficient way to identify potential measles cases before the person enters the healthcare setting and exposes others to the virus, strengthening the identify-isolate-inform response.