# Healthcare workers' views on the response to COVID-19 in long-term care hospitals in Korea: a mixed-method study

## TL;DR

This study explores how long-term care hospitals in Korea responded to the challenges of the COVID-19 pandemic and the effectiveness of their business continuity plans.

## Contribution

The study provides new insights into the operational challenges and responses of long-term care hospitals during the pandemic using a mixed-method approach.

## Key findings

- Most long-term care hospitals had business continuity plans, but over half found them ineffective.
- Six key themes were identified to explain how these hospitals managed pandemic-related challenges.
- Dedicated infectious disease teams were rare before the pandemic, highlighting a gap in preparedness.

## Abstract

Long-term care hospitals (LTCHs) faced challenges beyond the scope of their previous practice in response to the pandemic. However, not much is known about LTCHs' responses and business continuity plans (BCPs) during the pandemic. We investigated attempts by LTCHs to maintain continuity of operation during COVID-19 in order to gain insight on how to support them in future crises.

A mixed-method design was used, comprising a survey and individual interviews, to understand the responses and measures taken to address the pandemic.

For LTCHs, inpatient ward operations were identified as an essential function. Following the government's recommendation, most (85.7%) confirmed having BCPs, but over half felt that the operational effectiveness of BCPs was inadequate. Only 9.5% formed teams dedicated to infectious disease emergency preparedness and response before COVID-19. Qualitative analysis identified six main themes that explained the efforts of the LTCHs: workplace culture and leadership, communication, human resources, safety, continuity of essential services, and financial and supply management. The themes explained the reasons for operational effectiveness and provided examples and context on how staff responded in small and medium-sized LTCHs during the pandemic, considering elements in health service continuity planning.

Management of significant changes forced by the pandemic necessitates preparing a response that considers key components beforehand, particularly for vulnerable healthcare facilities. To address unexpected crises, LTCHs should develop, implement, and practice well-thought-out plans to enhance organizational resiliency and ensure continued hospital functioning.