Project Report

Decommissioning and recommissioning a regional hospital in response to a COVID-19 outbreak

AUTHORS

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Colleen Cheek1
PhD, Assistant Director of Nursing Education and Research *

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Hayley Elmer2
MACN, Nursing Director of Operations

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Tara Anderson3
FRACP, FRCPA, Infectious Diseases Physician and Clinical Microbiologist

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Trent Baxter4
GradCert Business, Acting Director of Corporate Services

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Maxine Wooler5
RN, Co-Director of Nursing

AFFILIATIONS

1, 2, 4, 5 Tasmania Health Service North West, PO Box 43, Burnie, Tas. 7320, Australia

3 Tasmania Health Service South, GPO Box 1061, Hobart, Tas. 7001, Australia

ACCEPTED: 10 February 2021


early abstract:

Context: The COVID-19 outbreak at the North West Regional Hospital (NWRH) site in Tasmania was both rapid and tragic. Within 10 days of identification of the first healthcare worker (HCW) infection, both hospitals had closed, and all patients discharged or decanted to other facilities within the State.   The entire hospitals’ staff (approximately 1300 people) and their households (approximately 3000-4000 people)1 were furloughed for 14 days to halt the spread of infection. During the furlough period, a decommissioning, terminal clean and recommissioning process was undertaken alongside recovery and reorientation of the workforce to Personal Protective Equipment (PPE).  Within four days of closure, an Australian Defence Force (ADF) and Australian Medical Assistance Team (AUSMAT) team opened the prioritised Emergency Department (ED) to provide emergency care for the local community, supported by modified diagnostic services.  The decommissioning and cleaning rolled on over the ensuing month, in a predetermined priority order. As staff returned from quarantine, they recommissioned their clinical areas. The final ward, a modified medical isolation wing, reopened on Day 29. 
Issue: Disaster management activities may be grouped under four main headings: prevention, preparedness, response and recovery2. While there are many opportunities for improvement and learning, this paper focuses on the local response and recovery, describing the process undertaken from the perspective of a small management group.  Authors CC, HE, TB and MW were on the ground during the decommissioning process, then managed aspects of the cleaning and recommissioning remotely from furlough.  Authors TA and TC provided specialist IPC support and developed education remotely.
Lessons Learned: Almost two months on, no new COVID-19 infections have been reported.  The aim of this paper is to provide a foundation for site-specific adaptation to include in pandemic escalation plans in other regional and rural settings.