Management of hospital care during the COVID-19 pandemic: Lessons learnt from five European countries

Background
The COVID-19 pandemic required significant adjustments in hospital management across Europe. This article explores the challenges faced and lessons learnt in managing hospital care, aiming to improve future pandemic preparedness and resilience.

Methods
Hospital management during the pandemic in Denmark, France, Germany, Hungary and Italy was investigated using a qualitative case study approach based on document analysis and 57 semi-structured interviews with senior hospital staff conducted in the spring and summer of 2022. The country case studies were subjected to an overarching analysis focusing on successes and failures in hospital pandemic management.

Results
Hospitals faced an overwhelming surge of patients, leading to the conversion of regular wards into COVID-19 units and the postponement of elective surgery, affecting the care of chronically ill and non-urgent patients. Telemedicine was crucial but faced challenges in terms of acceptance by elderly patients and physicians. Staff shortages and high workloads affected patient care and staff wellbeing. In addition, shortages of medical supplies led to a re-evaluation of logistics and warehousing. Many hospitals found existing policies and pandemic plans inadequate, leading to the formation of internal task forces.

Conclusion
The pandemic highlighted gaps in hospital preparedness and the need for improved resilience. Strategies to improve pandemic resilience, such as better working conditions and collaboration with primary care, would also improve health system performance in "normal times". Pandemic-specific measures, such as postponing elective surgery, are necessary but need to be carefully managed to minimise the negative impact on overall patient care.