TABLE 1.
Operational management | Role/Description |
---|---|
Epidemic Committee Disaster Management Team Communicable Disease Control Department Disaster Preparedness and Management Team |
The hospital's epidemic committee, which had for years worked on hospital‐wide epidemic and disaster preparedness, was activated at the earliest notification of the pandemic to prepare for the imminent disaster in collaboration with the hospital's disaster management team and the Communicable Disease Control Department of the hospital. When the crisis level rose, the disaster preparedness and management team, which in the end included all members of the hospital's executive board, took over the operational management of the hospital (Samuel & Benedikz, 2020). |
Experience from previous epidemics Clinical procedures |
Previous experience from the Ebola epidemic in 2014 had shown the significance of having infectious disease specialists trace and keep contact with individuals who had travelled to infected areas and had possibly come into contact with infected people. Through remote guidance, mainly by telephone, infectious disease specialists had guided these people in taking care of themselves at home. When necessary, infectious disease specialists admitted them to the hospital. This was repeated for the COVID−19 infected patients at the outset of the pandemic (Guðlaugsson, 2020). Knowledge of some key symptoms of the disease and information on appropriate clinical procedures started to emerge at this time, and was quickly incorporated into the care (Greenhalgh et al., 2020; WHO, 2020). |
Interdisciplinary Steering Committee | With the growing number of infected patients, the service needed to be expanded. An interdisciplinary steering committee was formed, which met twice daily during the whole emergency period, to coordinate and develop services in the outpatient clinic. The steering committee consisted of the Head of Division of Clinical Services II, the Director of Internal Medicine and Rehabilitation Services, the Director of Surgical Services, three head nurses, two chief physicians, one medical resident and a project manager (Helgason et al., 2020). One of the chief physicians was the chief of medical care in the clinic and one of the nurse managers was the head of nursing care (S.H.S.). The nurse manager delegated tasks to the other two nurse managers; to oversee the nursing care provided in the telehealth service (E.D.R.), and to coordinate the set up physical facilities and order technical and treatment resources (G.Ó.). A nurse manager was responsible for working with the hospital's informatics department in developing the electronic health record (A.H.). The project manager who worked for the steering committee was the editor of numerous procedures and guidelines on the COVID−19 patient care that were prepared and used in various parts of the hospital and other healthcare institutions around the country (S.I.). |
Recruitment of manpower | Infectious disease specialists, internists, internal medicine trainees, junior medical residents, junior medical staff, and a large group of nurses particularly from outpatient clinics of the hospital and clinical nurse specialists from various specialties, as well as nurses from a contingency pool, organised by the government, were temporarily transferred, or recruited for the COVID−19 outpatient clinic. |
Information technology | The Information Technology Department was activated to collaborate with clinical staff and others on a wide variety of issues, including a special charting system in the patient electronic health records and a colour coding system to identify patient acuity level. |