The COVID-19 Pandemic and Landspitali's Operating Room and Intensive Care Unit

Abstract

The COVID-19 pandemic, one of the most serious public health hazards of recent times, led to a high number of hospitalisations. The pressure on intensive care units has been significant. In many countries, including Iceland, there was a need to increase the capacity of these units to meet the growing demand for intensive care spaces, especially at the start of the pandemic. At Landspitali, the National University Hospital of Iceland (hereafter referred to as Landspitali), increasing unit capacity was a large-scale and extensive project where project management methodologies were utilised to assess risks and develop response plans. Using information gathered from interviews, this study explores the experience of managers in Landspitali’s surgical and intensive care unit in preparing for the pandemic and their evaluations of the project\'s success. The interviews were conducted in the autumn of 2020 after the first wave of the pandemic had passed in Iceland. The study utilised a qualitative methodology. Eight managers from Landspitali’s surgical and intensive care unit participated in semi-structured interviews. The study employs thematic analysis to analyse the findings. The data analysis reveals four themes. The first theme, ‘dealing with the unknown’, illustrates the uncertainty that was prevalent at the beginning of the pandemic. The second, ‘one step ahead’, reveals how the managers utilised resources both within and outside the hospital to prepare the intensive care unit for COVID-19 patients. The third theme, ‘fighting the virus’, highlights the challenges the managers encountered throughout the process. Lastly, the ‘in this together’ theme focuses on how the staff came together to accomplish the project. The initial uncertainty during the preparation phase posed difficulties for the managers. Working in accordance with existing response plans and utilising the findings of the situation analysis made it possible for managers to organise how space, personnel, and supplies would be utilised and thus increase the surge capacity of the units. The respondents\' main challenges were facility adaptation and ensuring adequate staffing. Cooperation and solidarity among the staff, along with well-timed preventive measures implemented by the authorities, proved crucial to the success of Landspitali’s intensive care unit in dealing with the pandemic.