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

Abstract

Context: The COVID-19 outbreak at the North West RegionalHospital (NWRH) site in Tasmania, Australia in April 2020 was bothrapid and tragic. Within 10 days of identification of the firsthealthcare worker infection, both hospitals had closed, and allpatients were discharged or decanted to other facilities within the state. The entire hospital staff (approximately 1300 people) andtheir households (approximately 3000–4000 people) werefurloughed for 14 days to halt the spread of infection. During thefurlough period, a decommissioning, terminal clean andrecommissioning process was undertaken alongside recovery and reorientation of the workforce to personal protective equipment.Within 4 days of closure, an Australian Defence Force andAustralian Medical Assistance Team team opened the prioritisedemergency department to provide emergency care for the localcommunity, supported by modified diagnostic services. Thedecommissioning and cleaning rolled on over the ensuing month,in a predetermined priority order. As staff returned fromquarantine, they recommissioned their clinical areas. The finalward, a modified medical isolation wing, reopened on day 29.Issue: Disaster management activities may be grouped under fourmain headings: prevention, preparedness, response and recovery.There are many opportunities for improvement and learning, and this article focuses on the local response and recovery, describingthe process undertaken from the perspective of a smallmanagement group. Authors CC, HE, TB and MW were on theground during the decommissioning process, then managedaspects of the cleaning and recommissioning remotely fromfurlough. Authors TA and TC provided specialist IPC support anddeveloped education remotely.Lessons learned: Almost 2 months on, no new COVID-19infections had been reported. The aim of this article is to provide afoundation for site-specific adaptation to include in pandemicescalation plans in other regional and rural settings