Navigating Pandemic Responsiveness in an Acute Care Setting: A Community Hospital’s Operational Experience with 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 used by a large community hospital located in Barrie, Ontario to manage COVID-19. Methods Guided by a qualitative descriptive approach, we conducted a thematic analysis of all COVID-19-related documentation discussed by the hospital’s Emergency Operations Centre (EOC) during the first pandemic wave. We solicited operational strategies from administrative leaders to construct a narrative for each theme. Results Seven recurrent themes critical to the hospital’s pandemic response emerged: 1) Organizational Structure: a modified EOC structure was adopted to increase departmental interoperability and situational awareness; 2) Capacity Planning: Design Thinking guided rapid infrastructure decisions to meet surge requirements; 3) Occupational Health and Workplace Safety: a multidisciplinary team provided respirator fit-testing, critical absence adjudication, and wellness needs; 4) Human Resources/Workforce Planning: new workforce planning, recruitment, and redeployment strategies addressed staffing shortages; 5) Personal Protective Equipment (PPE): PPE conservation required proactive sourcing from traditional and non-traditional suppliers; 6) Community Response: 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) Corporate Communication: a robust communication strategy provided timely and transparent access to rapidly evolving information. Conclusions The hospital benefited from an interconnected command structure that focused on inter-operability, communication, novel administrative tools, and community partnerships.