Childrens of Minnesota

Containing an Outbreak Through Preparation and Collaboration

Patsy Stinchfield, MS, RN, CNP, CIC
Adriene Thornton, RN, MA, CIC
Julie LeBlanc, MPH, CIC
Wendy Berg, BSN, RN, CIC
Jennifer Boe, BSN, RN, PHN, CIC
Joseph Kruland, MPH, CIC
Martina Korinek, MPH, CIC
Children’s Hospital and Clinics of Minnesota
Minneapolis, Minnesota

the infection prevention and control (IPC) team at Children’s Hospital and Clinics of Minnesota effectively employed their experience and relationships to rapidly contain the largest state measles outbreak in 30 years.

“Unfortunately, we’re experienced in measles outbreaks,” said Patsy Stinchfield, senior director of IPC. “But it helped us be prepared.” When Children’s identified the first measles case in April 2017, established IPC processes and systems gave the team a head start on containment. These included an “empty and ready” spreadsheet to track individual patient details, an electronic medical record that generated reports detailing potential in-hospital exposures, and the knowledge that Children’s staff was MMR-vaccinated. “You don’t want to be building the plane and flying it at the same time,” Stinchfield said. “The clock is ticking.”

The organization mobilized by using the Hospital Incident Command System (HICS). “We designated a single process of communication and emphasized that HICS only works if everyone follows it,” Stinchfield said.

IPC team member Adriene Thornton highlighted the importance of strong, cross-hospital relationships in an outbreak. “Make friends and keep them. You’ve got to have good relationships in order to mobilize people quickly,” she said.

Children’s IT department established a phone bank for exposed patients, and the IPC team recruited other nurses to make exposure calls while facilities converted ED rooms for airborne isolation.

The Children’s team also helped contain the outbreak statewide by partnering with the Minnesota Department of Health to assist with at-home patient management and sharing information about their interventions in statewide clinicians’ conference calls.

Ultimately, the Children’s IPC team helped end the measles transmission within five months and a total of 75 cases, while also improving patient management and fostering IPC relationships statewide.