Table 1.

Exploration, Installation, and Implementation of the intervention.

	Exploration	Installation	Initial Implementation	Full implementation
Hospital regulatory body	•PCR-based screening deemed infeasible in pilots •Prompt decision for RDT-based screening following inhouse RDT evaluation	•Timely setup of stable RDT supply chains •Development of information and training material •Initial rollout to selected wards/clinics to allow gradual routinization	•Order of implementation based on risk assessment of the respective patient-provider encountersa	•Continuous reevaluation of screening priorities based on infection dynamics (e.g., screening of contractors or visitors)a
Hospital departments	•High general acceptance of the need for screening •Initial skepticism due to concerns regarding RDT validity	•Challenge selecting staff to undertake implementation (concerns regarding staff shortage and workload distribution)b , c •Rapid set-up of initial screening infrastructure, including rooms, IT, materiala	•Increasing openness and “euphoria” following the first asymptomatic cases being detected through screeninga •High acceptance of screening-associated disruptions of clinical workflow •Increased sense of security associated with screening	•Tensions regarding who receives screening services, and who performs this screeningb , c •Increased reports of false negatives lead to disillusionment for somec
Providers		•Rapid setup of infrastructure and training for peers •Development of ward-specific implementation strategies to reflect logistical, client, and personnel characteristicsa	•Increasing routinization of screening proceduresa •Mitigation of initial challenges (incl. infrastructure, administration, IT) •Burden of shifting workloads (integrate screening into already high workload; compensate the absence of staff shifting to full-time screening)b , c	•Burden of rapidly increasing workload and “trench fights”a , c •Difficulties reacting to repeated changes in implementation regulations and infection dynamicsa , b , c •Perception of changing test characteristics (e.g., specificity, swab quality) •Skepticism of RDT utility with certain populations (e.g., small children, patients with dementia)
Patients			•Generally high acceptability of screening and associated burdens (e.g., unease with swabbing, waiting times) •Explicit expectation of screening procedures to be implemented at a university hospital during a pandemic	•Increasing awareness of alternative tests (comparing RDT and PCR, option of anterior-nasal sampling etc.)

^aExemplified in Exemplary Case 1.

^bExemplified in Exemplary Case 2.

^cExemplified in Table 2.