ADHERENCE TO UNIVERSAL TRAVEL SCREENING IN THE EMERGENCY DEPARTMENT DURING EPIDEMIC EBOLA VIRUS DISEASE

Background: During the 2014 West African Ebola Virus Disease (EVD) outbreak, the U.S. Centers for Disease Control and Prevention recommended that all emergency department (ED) patients undergo travel screening for risk factors of importingEVD. Objectives: We sought to determine the overall adherence rate to the recommended travel screening protocol and to identify factors associatedwith nonadherence to the protocol. Methods: We conducted a multicenter, retrospective analysis of adherence to the travel screening program in an academic hospital and three affiliated community hospitals. Aregression model identified patient and hospital factors associated with nonadherence. Results: Of the 147,062 patients included for analysis, 93.7% (n = 137,834) had travel screenings completed. We identified several characteristics of patients that were most likely to be missed by the screening protocol-patients with low English proficiency, patientswho arrive viaambulance or helicopter, and patientswith more severe illness or injury based on initial triage acuity. Conclusions: These findings should be used to improve adherence to the travel screening protocol for future emerging infectious disease threats. (C) 2018 Elsevier Inc. All rights reserved.