Pandemic Responsiveness in an Acute Care Setting: A Community Hospital's Utilization of Operational Resources During COVID-19.

Background: To ensure continuity of services while mitigating patient surge and nosocomial infections during the coronavirus disease 2019 (COVID-19) pandemic, acute care hospitals have been required to make significant operational adjustments. Here, we identify and discuss key administrative priorities and strategies utilized by a large community hospital located in Ontario, Canada.

Methods: Guided by a qualitative descriptive approach, we performed a thematic analysis of all COVID-19-related documentation discussed by the hospital's emergency operation centre (EOC) during the pandemic's first wave. We then solicited operational strategies from a multidisciplinary group of hospital leaders to construct a narrative for each theme.

Results: Seven recurrent themes critical to the hospital's pandemic response emerged: 1) : a modified EOC structure was adopted to increase departmental interoperability and situational awareness; 2) : Design Thinking guided rapid infrastructure decisions to meet surge requirements; 3) : a multidisciplinary team provided respirator fit-testing, critical absence adjudication, and wellness needs; 4) : new workforce planning, recruitment, and redeployment strategies addressed staffing shortages; 5) : PPE conservation required proactive sourcing from traditional and non-traditional suppliers; 6) : local partnerships were activated to divert patients through a non-referral-based assessment and treatment centre, support long-term care and retirement homes, and establish a 70-bed field hospital; and 7) : a robust communication strategy provided timely and transparent access to rapidly evolving information.

Conclusion: A community hospital's operational preparedness for COVID-19 was supported by inter-operability, leveraging internal and external expertise and partnerships, creative problem solving, and developing novel tools to support occupational health and community initiatives.