Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study

Table 5

Examples of operational changes across different resource domains over the study period.

Resource domain	Resource example	Operational changes
Material	Facilities	Reconfiguration of existing 4 ICUs for infection control
		Opening of 3 new ICUs in non-conventional areas
		ICU capacity expansion from 69 to 129 beds on short notice
		Reconfiguration of a number of wards for COVID-19 isolation
	Equipment	Reallocation or loan of 26 ventilators
		Reallocation or loan of 12 RRT machines
		Redeployment of 38 anaesthetic machines
		Reconfiguration of electronic health record for additional bed capacity
	Expendables and medicines	Supply chain focus on availability of PPE
		Rationalised use of sedatives and RRT fluids
Workforce	Staff	Redeployment of consultant Anaesthetists
		Redeployment of staff from other departments (56 nurses, 39 doctors)
		Formation of teams for intubation, prone positioning, transfer, and tracheostomy
		Reorganisation and expansion of senior rota with 24-hour consultant presence
		Staff wellbeing and support initiatives
Human resources	Time and Labour	Reconfiguration of entire critical care service delivery model to include extra capacity, processes and staff
		Development of new treatment guidelines, protocols and SOPs (22 documents)
		Development of training and simulation material
		Provision of training and simulation (28 training sessions via teleconference)
	Organisation	Provision of CPAP outside the ICU by Respiratory physicians
		Provision of dialysis (27 patients) and peritoneal dialysis (11 patients) in the ICU
		Reconfiguration of Governance and Risk management

Abbreviations: PPE, personal protective equipment; RRT, renal replacement therapy; AHP, allied health professions; SOP, standard operating procedure; CPAP, continuous positive airway pressure.