Impact of policy regulations on the functioning of hospitals in Poland during the COVID-19 pandemic: a qualitative analysis

recommendation to facilities with infectious wards to follow procedures in case of COVID-19 emergency – list of infectious hospitals: – Designation of rooms/isolation in hospitals that have infectious wards

No action taken

recommendation for persons returning from northern Italy to observe their health condition and in case of deterioration to be isolated or to contact the nearest infectious diseases unit

in general hospitals, to create a separate entrance for patients with symptoms of infectious disease and to follow the classification algorithm

need for staff in contact with persons suspected to have SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection to wear masks

No action taken

March 2 – Act of March 2, 2020 on special solutions for preventing, counteracting, and combating COVID-19, other communicable diseases, and emergencies caused by them

to lay down rules for remote working to minimize the risk of infection among staff

increase of the sickness benefit from 80% to 100% of the benefit assessment basis calculated on the basis of the provisions of the Act on cash benefits from social insurance in case of sickness and maternity

granting care allowances due to the necessity of taking care of a child in person in the situation of closing a day nursery, children's club, kindergarten, school, or other institution which the child attends

introduction of the possibility to provide health care services by means of teleportation, – the principles of disposal of contaminated medical waste generated in relation to COVID-19 were specified,

March 3 – Call of the President of the Supreme Council of Nurses and Midwives on the sanitary-epidemic and medical procedures in connection with the risk of outbreak of the new coronavirus (SARS-CoV-2) on the territory of Poland addressed to medical professionals – nurses, midwives, health sector managers, and public authorities

a recommendation to nursing and midwifery staff to strictly observe sanitary-epidemiological standards and procedures implemented in places of assistance

an appeal to managers of medical establishments to provide safe workplaces for their staff, equip them with the necessary personal protective equipment, and conduct practical training on the prevention of SARS-CoV-2 infection

March 5 – Letter from the Health Department of the Silesian Voivodeship Office in Katowice of 5 March presenting the recommendations of Voivodeship Consultants in obstetrics and gynecology

List of entities providing obstetric-gynecological services for pregnant women diagnosed with or suspected to have COVID-19 infection

March 8 – Order No. 32/2020/DSOZ of the President of the National Health Fund on the report and conditions for settlement of healthcare services related to the prevention, counteraction, and eradication of COVID

indication of financial rates for hospitalization of a patient suffering from COVID-19

providing financial resources to providers of services in the fight against COVID-19

March 25 – Recommendations to single-named hospital and infectious disease unit workers to limit work activity in other sectors

March 26 – Regulation of the Minister of Health of March 26, 2020 amending the Regulation on the training of nurses and midwives transfusing blood and its components

extending the validity of certificates by 6 months

March 31 – Act of March 31, 2020 on amending certain acts in the health care system related to preventing, counteracting, and combating COVID-19

introduction of the possibility for nurses and midwives, regardless of their education, to perform medical on-call duty in medical entities providing services 24 h a day

introduced shortening of the time of training after a break in exercising the profession

The possibility of qualifying donors for the donation of blood or blood components by nursing staff has been introduced.

Sick pay is increased from 80% to 100% for medical and nursing staff in compulsory quarantine.

the possibility for nursing staff to give tele-treatments

March 2 – Order No. 19/2020 of March 2 on the organization of WSS2 in connection with security measures against the SARS-CoV-2 epidemic and in the event of a patient presenting with suspected infection

a team responsible for organizational activities related to epidemic-proofing has been established

isolation areas have been identified

March 5 – Procedure to be followed in case of suspected infection with SARS-CoV-2 – Emergency Room, POZ (Primary healthcare), NaHH (Night and holiday healthcare): – necessity to interview the patients about their state of health – patients with suspected infection are directed to the “Admission Room – Coronavirus” entrance – use of protective clothing provided by the hospital to the staff.

to close all entrances to the hospital between 20:00 h and 5:00 h

to require the ward staff to ensure that visitors have left the hospital premises by 19:30 h at the latest

March 10 – Order No. 22/2020 of March 10 on the introduction of organizational changes in WSS2 related to the epidemiological situation caused by SARS-CoV-2:

introduction of pre-qualification of patients based on the questionnaire in the format prescribed, which was administered to patients suspected of having SARS-CoV-2 infection through a barricade that was specifically created for this purpose (in a tent closely adjacent to the side entrance to the hospital)

three organizational zones were introduced: red for hospital employees; green for patients of the specialist clinic, primary care, laboratory, and physiotherapy laboratory; and blue for patients of hospital wards, dialysis station, NaHH, and Diagnostic Imaging Department

Patient labelling with color-coded identification bands is introduced.

March 13 – Information from the Director about the introduction of a ban on the entry of clergy into hospital premises; an exception to the ban is made in life-threatening situations

March 16 – Suspension of all admissions for hospitalization/treatment/tests planned until further notice

prohibition of laboratory staff (subcontractor) from entering hospital premises; codes have been introduced to separate medical and administrative areas

March 17 – Rules on collection, characterization, and transport of biological material for laboratory testing for SARS-CoV-2 by real time PCR (The coronavirus PCR test is a genetic test to confirm SARS CoV-2 virus infection)

only a doctor of infectious diseases may order testing for COVID-19

only a physician may perform SARS-CoV-2 testing

specific procedures are given for the preservation of the biological material collected

work of specialist outpatient clinics was restricted

all planned admissions to hospital, treatments, and examinations were suspended (until further notice), except for oncology patients, drug programs, and KOS – infarction (cardiac care and rehabilitation programme)

performance of sterilization services for external entities suspended

relocation of primary care outpatient clinics to NaHH premises

a schedule was established for the availability of physicians on call for patients of specialist clinics and wards of the hospital

Information was provided to the hospital emergency room on referring patients with suspected or actual infection to specific treatment centers.

information to managers of organizational units (head of department) on absolute limitation of interdepartmental consultations, use of available means of communication (telephone, e-mail), absolute ban on transferring paper documentation between units

March 18 – Isolation procedure for patients infected with SARS-CoV-2 and use of personal protective equipment by staff

segregation of so-called “isolation” rooms and marking of these rooms

segregation of staff, on each shift, dealing with patients suspected of or infected with COVID-19 staying in isolation rooms

visits to the patient are prohibited

meals to be served in disposable containers

the need for staff leaving the isolation room to maintain complete hygiene

there is a precise sequence for putting on and removing personal protective equipment, which is disposable

April 3 – Ordinance of the Minister of Health of April 3, amending the Ordinance on the handling of remains and human remains

April 15 – Ordinance of the Minister of Health of April 15, 2020 amending the Ordinance on general terms and conditions of contracts for the provision of healthcare services

sets out detailed rules for the settlement of services contracted with the NFZ (National Health Fund) in the event of discontinuation of services under the concluded agreements for the treatment of patients infected with SARS-CoV-2

April 16 – Law of April 16, 2020 on specific support instruments in connection with the spread of the virus

Specified working hours, daily rest in health care services for the duration of the epidemic

April 17 – Guidelines of the team of epidemiological nursing consultants for measures to prevent the spread of SARS-CoV-2 infections in the hospital environment

define the conditions for isolation of patients with suspected or actual infection, the rules for maintaining cleanliness during isolation, handling the patient's linen, medical waste, and food,

determination of rules for handling dead bodies of infected persons

April 19 – Regulation of the Council of Ministers of April 19, 2020 on the establishment of certain restrictions, orders, and prohibitions in connection with the occurrence of an epidemic

April 21 – Ordinance of the President of the National Health Fund of April 21, 2020 amending the Ordinance on the principles of reporting and conditions of settlement of healthcare services related to the prevention, counteraction, and eradication of COVID-19

the possibility of concluding contracts for performing diagnostic RT-PCR tests for SARS-CoV-2 and their settlement was introduced

April 24 – Communication from the Minister for Health – referral for work to combat epidemics

presentation of remuneration to persons assigned to work to combat epidemics

April 25 – Polish diagnostic-therapeutic and organizational recommendations for the care of persons infected or exposed to SARS-CoV-2 infection:

defined the principles of pharmacotherapy, oxygen therapy, and management of patients in the ICU (intensive-care unit)

recommendations for the protection of medical personnel against infection are included

April 28 – Ordinance of the Minister of Health of April 28, 2020 on standards for restrictions on the provision of healthcare services to patients other than those suspected of or infected with SARS-CoV-2 by medical professionals having direct contact with patients with suspected or actual infection

changes have been introduced for medical professionals working with patients suspected of or infected with SARS-CoV-2, restricting their work with healthy patients

April 30 – Communication from the National Health Fund on additional measures for persons providing services in entities in connection with the COVID-19 outbreak

April 2 – Order No. 36/2020 of April 2 on organizational changes to minimize the risk of SARS-CoV-2 infection

change in the organization of work in the administration area concerning, inter alia, matters related to the circulation of paper documentation, e.g., issue of pay slips, transmission of statistical cards to the Medical Statistics Department, issue of personnel certificates

closed-door office operation and reduction in personal contacts

April 3 – Decision of the Director on the detailed method of transmitting intra-hospital correspondence

April 6 – Director's recommendation to separate single rooms in each ward for initial isolation of patients with justified suspicion of infection (number of rooms depends on needs)

April 7 – Agreement between the Hospital Director and Trade Unions

the settlement period was extended from April 1, 2020 to December 31, 2020

an equivalent working time system was introduced, which allowed the daily working time to be extended to 12 h

shift work in administration was introduced

Information from the Director specifying the rules for delivering packages for hospitalized patients

April 14 – Procedure in ZOL (Care and Treatment Facility), ZPO (Health care team), and NaHH, POZ – in the case of suspected patient infection with SARS-CoV-2

Designation of three entrances to the building (second hospital location):

Entry No. 1: main entrance to ZOL, ZPO, NaHH–pediatric patients

Entrance No. 2: main entrance to POZ, NaHH–adult patients

Entrance No. 3: entrance to the staff bathroom after contact

rules of handing over packages for patients in ZOL and ZPO are defined

determines the procedure in the event of a patient presenting to the POZ and NON-POZ

April 15 – Order No. 39/2020 of April 15 on the isolation area for internal medicine patients suspected of SARS-CoV-2 infection requiring hospitalization

conversion of the Rehabilitation Ward into an isolation area

The principles of organization of work of the medical and nursing staff in the newly established isolatorium were determined.

recommendation of the director concerning the introduction of new principles of collecting material for testing for SARS-CoV-2

the need to take a swab for all patients to be hospitalized in the wards of the hospital

a special room was prepared for swabbing patients for planned hospitalization

April 16 – Director's decision on the introduction of new rules for patients reporting for examinations in the Diagnostic Imaging Department

April 23 – Director's order to change the place and hours of delivery of parcels for patients

April 27 – Management and organization of work in the operating theatre in the case of a patient suspected of or diagnosed with SARS-CoV-2 infection

separate operating rooms for gynecological-obstetric patients suspected of or infected with SARS-CoV-2 in order to perform emergency Cesarean sections or natural deliveries

defined rules for the work of the surgical, anesthetic, neonatology, and cleaning teams

the procedure for the management of suspected SARS-CoV-2 infection in a trauma patient

indicates the principles for management of trauma patients infected with SARS-CoV-2 in the emergency room, operating theatre, and Diagnostic Imaging Department, and indicates the contact details of medical entities that have infectious wards treating trauma patients within their structure

defined management in the pediatric emergency room of a patient asymptomatic for SARS-CoV-2 but in contact with a person in whom SARS-CoV-2 infection has been confirmed and a patient with symptoms for infection

preparation of an isolation room for a child suspected of SARS-CoV-2 infection

Order 43/2020 of April 30 on the amendment of Order No. 22/2020 of March 10 on the introduction of organizational changes related to the epidemiological situation caused by SARS-CoV-2

pre-qualification of persons presenting themselves at specialized clinics has been introduced

April 30 – Order 44/2020 of April 30 on the resumption of physiotherapy workshops for outpatient physiotherapy and day center and specialist outpatient clinics

obliged the manager of the physiotherapy laboratory, the managing physician of the Rehabilitation Ward, and the manager of specialist outpatient clinics to draw up a schedule of patient admissions and to establish rules for the safe provision of services

the rules of initial qualification (sluice) of patients reporting to the physiotherapy area and specialist outpatient clinics are specified in detail

May 2 – Regulation of the Council of Ministers on the establishment of certain restrictions, orders, and prohibitions in connection with an epidemic situation

May 4 – Announcement of NFZ Headquarters regarding the provision of medical rehabilitation services

possibility of re-establishing activity in the scope of inpatient and outpatient rehabilitation

possibility of full-scale reinstatement of inpatient rehabilitation centers/units

May 5 – Message from NFZ Central Office to healthcare providers regarding SZOI portal (Information Management System)

updated documentation on electronic verification and confirmation of medical device orders

May 6 – Recommendations for the organization of long-term care services during the COVID-19 pandemic

limiting visits to patients

reducing to a minimum the number of staff required to work with patients in the long-term care area (separation of nursing sub-units and units)

limitation of employment of medical personnel

use of ICT systems by doctors to consult patients in long-term care facilities

May 8 – Resolution No. 321/2020/VII of the Regional Council of Nurses and Midwives in Katowice of May 8, 2020

A special financial aid for the members of the District Chamber of Nurses and Midwives in Katowice granted in the event of infection with the virus

May 11 – Communication of the Minister of Health concerning the possibility to perform a swab for COVID-19 on the 12th day of quarantine, under the condition of self-transport, without contact with other persons

announcement from the National Health Fund Headquarters about increasing the number of available swab points for SARS-CoV-2

communication of the Minister of Health on family childbirth

the need for a negative PCR test for COVID-19 for the person accompanying the childbirth

the need for an epidemiological interview of the pregnant woman and the attendant

the length of time the attendant has to stay at the birth is specified

May 12 – Regulation of the Minister of Health amending the regulation on the organizational standard of care in isolation facilities

May 29 – Regulation of the Council of Ministers of May 29, 2020 on the establishment of certain restrictions, orders, and prohibitions in connection with the occurrence of an epidemic

discontinuation of health services provided in mobile vehicles

discontinuation of rehabilitation services provided under contracts awarded by ZUS (Social Insurance Institution)

May 8 – Director's recommendation on the organization of work in the event of an influx of large numbers of patients suspected of or infected with SARS-CoV-2

the need to report the current occupancy and severity status of patients, vacant ventilators, and staff status

the order of procedure was established: suspension of admissions in the Admissions Chamber and reorganization of wards in case of exhaustion of isolation places in wards (Otolaryngology)

May 13 – Information from the Director on the launch of the electronic sending of payslips; creation of e-mail service boxes for each staff member, irrespective of the form of employment

May 21 – Procedure for dealing with patients admitted to hospital on an elective basis given the risk of transmission of the SARS-CoV-2 epidemic

define scheduled admissions to all wards of the hospital, with detailed epidemiological history taking by telephone before scheduled admission

defined planned admissions to the ward not exceeding two patients per day, except for ZOL and ZPO

it was recommended to perform a swab prior to admission for COVID-19

the rules of informing about admissions by the registration of the Admissions Chamber are specified

May 25 – Director's information on requiring staff to self-measure their body temperature before entering hospital premises. Director's recommendation regarding reporting of isolation vacancies in wards

May 27 – Director's recommendation defining rules for limited work in specialist clinics: one doctor = 10–12 patients; two doctors in Trauma and Orthopedic Clinic (previously 5)

May 29 – Director's decision on the mandatory maintenance of the national COVID-19 patient register (with effect from June 1, 2020)

WHOLE MAY – Establishment of “swabbing” teams within the framework of the established cooperation with the Pniówek mine in order to perform swabs for the presence of SARS-CoV-2 among the mine employees

June 1 – Message from NFZ Headquarters: – The possibility of resuming the operation of spas from June 16 only for patients with a negative diagnostic test result for SARS-CoV-2

June 3 – Communication from the Minister of Health – Update on recommendations concerning COVID-19 outbreak for family/primary care midwives

June 16 – Communication from the Minister of Health on the allocation of funds for the fight against the epidemic

Appropriation of funds from the program Knowledge Education Development for salary supplements for the staff of nursing homes, residential care units, and hospices, as well as for purchase of personal protective equipment and disinfectants, for the period of the COVID-19 pandemic

June 17 – Order of the President of the NFZ No. 86/2020/DEF on the change of the financial plan of the National Health Fund for 2020

Increase of costs of healthcare services in voivodeship plans by PLN 302.679 million.

specified the duration of quarantine until a negative COVID-19 test result is obtained

June 19 – Information of the National Health Fund of June 19, 2020 on the possibility of settlement of diagnostic tests for SARS-Co-V-2 in medical students doing their student internships in medical institutions

regulation of the Council of Ministers on the establishment of certain restrictions, orders, and prohibitions in connection with the occurrence of an epidemic

June 26 – Regulation of the Minister of Health on the amount of basic monthly remuneration of physicians and dentists undergoing specialization within the framework of residency

determines the adjustment of remuneration of doctors during their residency

June 29 – Ordinance of the Minister of Health of June 29, 2020 amending the Ordinance on infectious diseases giving rise to the obligation of hospitalization, isolation, or home isolation and the obligation of quarantine or epidemiological surveillance

established a quarantine period for persons who had contact with an infected person of 14 days

June 3 – Information from the Director regarding the suspension (until further notice) of elective admissions due to the lack of isolation places for patients

June 17 – Director's recommendation to change the entrance to the NaHH

June 30 – Director's message on changing the entrance for patients reporting to specialist clinics and physiotherapy laboratories, with a new route for dependent patients and those in wheelchairs

crossing of traffic routes between patients and administrative staff

July 2 – Communication from the Minister of Health

a higher valuation has been established for POZ and AOS (Outpatient specialist care) facilities that issue electronic referrals

July 15 – Order of the President of the NFZ No. 109/2020/DEF on release of general reserve included in the financial plan of the National Health Fund for 2020

request for release of the general reserve in the amount of PLN 1.000 million

July 20 – Ordinance of the Minister of Health amending the ordinance on standards for restrictions on the provision of healthcare services to patients other than those suspected of or infected with SARS-CoV-2 by medical professionals having direct contact with patients suspected of or infected with SARS-CoV-2

introduced the possibility of providing services by restricted personnel only with the consent of the head of the health care unit

July 30 – Message from the Ombudsman

removes the stipulation necessitating attendants at family births to show a negative COVID-19 test result

July 16 – Information from the Director dated July 16, 2020 regarding the separation of the “SARS-Co-V-2 diagnostic area for elective admissions” and the schedule of swab collection by individual departments

July 28 – Information from the Director on resumption of admission of patients for elective procedures

August 7 – The Ombudsman's communication

impunity of doctors for manslaughter or grievous bodily harm is introduced

August 12 – Ordinance of the Minister of Health on the organizational standard of teleportation in primary health care

August 14 – Law of August 14, 2020 on amending certain laws to ensure the functioning of health care in connection with and after the COVID-19 pandemic

August 18 – Order of the Minister of Health on the appointment of a Team for purchasing COVID-19 vaccine

The term of office of the bodies of the professional chambers of medicine has been extended.

August 25 – Order of the President of the NFZ No. 130/2020/DEF on the change of the financial plan of the National Health Fund for 2020

costs of healthcare services in regional branches were increased to the total amount of PLN 1.093.166 million

introduced obligation for doctors to report services provided remotely

August 27 – Communication from the Ministry of Health

the quarantine period for asymptomatic persons has been shortened to 10 days

August 18 – Director's note dated August 18, 2020 regarding the forwarding of paper correspondence to and from the main secretariat by designated secretaries at specific times

September 1 – Ordinance of the Council of Ministers of September 1, 2020 amending the Ordinance on the establishment of certain restrictions, orders, and prohibitions in connection with the occurrence of an epidemic

specified the necessity of a negative diagnostic result test for SARS-CoV-2 taken not earlier than 6 days before the designated date of admission to ZOL or ZPO (tests financed from public funds)

reduced quarantine period to 10 days

September 3 – Decision of the Silesian Voivode – WSS2 was instructed to prepare beds for patients with suspected SARS-CoV-2 infection, which meet the requirements ensuring prevention of the virus infection (isolation rooms)

September 5 – Communication from the NFZ Headquarters on the recommendation of PCP (primary care provider) doctors to test for SARS-CoV-2

September 10 – Communication from the Minister of Health – rapid antigen tests allowing identification of the virus in 10–30 min have been allocated to EDs and Admissions Chambers

September 15 – Information to the President of the National Health Fund on SARS-CoV-2 screening for students of medical faculties and students of post-secondary schools training for medical professions

September 23 – Recommendation of the National Health Fund of September 22, 2020 with reference to the decision of the Voivode of September 3, 2020 to provide information on the cells in which isolation beds of level I were separated

September 23 – Communication from the Ministry of Health – rules for ordering SARS-CoV-2 tests and detailed algorithms for the management of independent and dependent patients have been established

September 8 – Response to the Voivode decision dated September 8, 2020

preparation of 22 places meeting the requirements in question:

OAiIT (anaesthesiology and intensive care unit) – one bed,

Department of Rehabilitation – one bed,

Neurosurgery Ward – two beds

Department of General Surgery – two beds

Department of Trauma and Orthopedic Surgery – two beds

Obstetrics and Gynecology Ward – one bed

Department of Otolaryngology – one bed

Urology Ward – one bed

Gastrologic and Internal Medicine Ward – one bed

Cardiology-Internal Ward – one beds

Ophthalmology Ward – one bed

Nephrology-Internal Ward – one bed

Dialysis Station – one bed

Neurology Ward – two beds

Pediatrics Ward – one bed

OICU (Obstetric Intensive Care Unit) – one bed

Accident and Emergency Department – one bed

September 10 – Announcement by the Director on the transfer of the NaHH for children to the second hospital site

September 15 – Procedure for visiting patients in special situations in ZOL and ZPO

September 21 – Information from the Director regarding the temporary closure of one of the two entrances/exits for hospital employees

September 29 – Order 103/2020 of September 29, 2020 on the organization of the work of WSS2 in connection with the epidemiological situation

entrance to specialist outpatient clinics reopened

Pre-qualification at the entrance to the green zone for outpatients was created.

Specific eligibility criteria were established

The main entrance was made available to patients collecting medical documentation (test results, discharges, photocopies of medical documentation)

A schedule is established for the issue of documentation by individual departments

October 7 – Information of the Silesian Voivode regarding the indication of medical entities that provide health services in selected specializations for infected patients

Act of October 7, 2020 amending certain acts to counteract the socio-economic effects of COVID-19

October 8 – The Ordinance of the Minister of Health of October 8, 2020 on the organizational standard of health care for patients suspected of or infected with SARS-CoV-2

specified detailed tasks of Primary Health Care physicians

Communication from the Minister of Health

16 coordinating hospitals have been established

Regulation of the Minister of Health of 8 October 2020 amending the regulation on the organizational standard of care in isolation facilities

possibility for HCPs to refer patients to an isolation facility

no need to refer people waiting for a test result to an isolatorium

October 14 – Decision of the Silesian Voivode of October 14, 2020 on the necessity to create 45 beds for COVID-19 patients (including 7 ventilator beds) in WSS2 from October 16, 2020 with simultaneous maintenance of 22 isolation beds from September 15, 2020

it was recommended to temporarily suspend scheduled services

October 19 – Communication from the Minister of Health

introduced a COVID-19 medical staff benefit of 100% for doctors, nurses, and paramedics

established 100% of remuneration for medics arriving in quarantine or isolation

voivodeship hospitals have been instructed to transform their internal medicine wards into “Covid” wards

October 20 – Decision of the Silesian Voivode concerning the reporting of: number of occupied and free beds for patients with suspected infection, number of occupied and free beds for infected patients, and number of occupied and free ventilator beds for infected patients

October 23 – Ordinance of the Minister of Health amending the Ordinance on the organizational standard of health care provision for patients suspected of or infected with SARS-CoV-2

Allows feldspersons to provide care for patients suspected of infection with SARS-CoV-2

October 24 – Announcement of the National Health Fund Headquarters – operation of health resorts suspended

October 28 – Announcement from the NHF Headquarters – conversion of some spa hospitals and sanatoriums into isolation facilities

October 30 – Information from the Consultant in Anesthesiology and Intensive Care Nursing on the necessity to prepare nursing staff to work with infected patients and to familiarize themselves within the framework of internal or individual training with materials concerning adaptation to work in the ICU and management of intubated patients – the information concerns the remaining nursing staff, i.e., those not experienced in work in the ICU

October 7 – Information from the Director about the need to immediately suspend admissions to the Ophthalmology Department due to the need to designate an area for ENT (Otolaryngology) patients, and to suspend the operation of the ophthalmology outpatient clinic

October 8 – Information from the Director on the need to immediately stop admissions to the Cardiology and Internal Medicine Department due to the need to prepare the Gastrologic and Internal Medicine and Nephrology Departments for hospitalization of patients with a positive test result for COVID-19 with simultaneous appointment of a contact person, update of reports once every 3 h

October 14 – Order 116/2020 of October 14, 2020 on the organization of work in connection with the epidemiological situation.

It was ordered to create hospital places for patients with a positive test result for SARS-CoV-2:

Gastrologic and Internal Medicine Department – 11 beds (October 16, 2020)

Rehabilitation Ward – seven beds (October 16, 2020)

Nephrology and Internal Medicine Ward – 18 beds (October 16, 2020)

Otolaryngology Ward – nine beds (October 22, 2020)

The establishment of an isolation facility for patients with unknown outcome was ordered:

Department of General Surgery – six beds

Trauma and Orthopedics Ward – six beds

an area was separated in the Ophthalmology Ward for the activity of the Otolaryngology Ward

the operation of the operating theatre was limited to two tables

admissions were suspended except for acute cases, oncology patients, children, and pregnant women

all medical staff were stopped from availing planned leaves, internships, and secondments

it was recommended to prepare seven “covidien” beds in the Anesthesiology and Intensive Therapy Department

it was recommended to change the organization of the admission room in order to eliminate the crossing of communication routes (emergency and COVID-19 patients)

October 22 – Information from the Director that in the newly opened ENT Department, medical care shall be provided by doctors of the Cardiology and Internal Medicine Department

October 27 – Director's recommendation on the daily appointment of a COVID-19 coordinating physician

October 28 – Information from the Director concerning a change of location of the Information Centre (place of collection and return of keys to the premises)

November 1 – Announcement from NFZ Headquarters: – Additional remuneration has been granted to the staff of EDs, emergency rooms, medical rescue teams, and laboratory diagnosticians in connection with the fight against the COVID-19 pandemic

November 2 – Regulation of the Council of Ministers of November 2, 2020 amending the regulation on the establishment of certain restrictions, orders, and prohibitions in connection with the occurrence of an epidemic state: – abolition of the obligation of quarantine for medical practitioners after the test

November 3 – Ordinance of the Minister of Health of November 3, 2020 amending the Ordinance on infectious diseases giving rise to the obligation of hospitalization, isolation, or home isolation and the obligation of quarantine or epidemiological surveillance: – recommended daily antigen test for personnel providing health services for a period of 7 days in order to avoid quarantine and thus removal from work

November 4 – Announcement from NFZ Headquarters – support has been granted to hospitals in the form of people working for the Territorial Defence Army in updating data on vacant beds

November 9 – Decision of the Silesian Voivode of November 9, 2020: – the need to create 145 beds for COVID-19 patients in WSS2 (130 oxygen beds for adults, 5 oxygen beds for children, 7 respiratory beds for adults, and 3 respiratory beds for children)

November 16 – Announcement from NFZ Headquarters – traditional hospitals have been divided into 4 types:

I level – hospitals for patients with suspected infection with SARS-CoV-2

II level – hospitals that treat patients infected with SARS-CoV-2

Level III – hospitals that treat patients infected with SARS-CoV-2, but the main reason for hospitalization is not COVID-19

Level IV – Hybrid hospitals, coordinating

November 18 – Information from the District Chamber of Nurses and Midwives on the new training rules for nurses returning to work after a break in their profession

November 26 – Order of the President of the NFZ No. 188/2020/DEF of November 26, 2020 on releasing the general reserve included in the financial plan of the National Health Fund for 2020: – general reserve was released for increasing the financing of healthcare services

November 27 – Decision of the Silesian Voivode

95 “covidien” beds including 15 ventilator beds to be opened in WSS2

November 28 – Act of November 28, 2020 amending the law on certain acts in connection with countering emergencies related to COVID-19: – increased the minimum wage from 150% of the basic wage to 200% in the entity to which the employee was referred – allowed paramedics to collect material for COVID-19 testing

November 5 – Information from the Director concerning the reopening of the Hemodynamics Laboratory

November 6 – Information from the Director in connection with reorganization of the work environment and organization of work in the Central Sterilisation Department, enabling decontamination of rooms by employees of the Sterilisation Department after SARS-Cov-2 infected patients have vacated them

November 12 – Director's briefing on the opening of further “covidium” beds

maintenance of 67 beds, i.e., 22 observation beds + 45 beds for positive patients including 38 oxygen beds [Nephrology – Internal Medicine (18), gastrologic – Internal Medicine (11), Laryngology (9), and 7 ventilator beds (Rehabilitation Ward)]

in the decision from November 30 to provide 145 beds for patients with confirmed SARS-Cov-2 infection

creation of a 12-bed ICU for infected patients, in place of the current anesthesiology and ICU

establishment of a five-station anesthesiology and ICU for COVID-19 negative patients on the other side of the Rehabilitation Ward

creation of a 10-bed (ultimately 46) ward for COVID-19 positive patients in the place of the current Trauma and Orthopedics Ward

reduction of the rooms occupied by the Neurology Ward and the Stroke Ward to rooms in one section

change of the location of the Trauma and Orthopedic Ward – rooms in the vacated part of the Neurology and Stroke Ward

November 16 – Information from the Director on the absolute prohibition to enter the Personnel Department

November 19 – Director's Order 145/2020 of November 19, 2020 on the organization of nursing staff work in view of the epidemiological situation

instructed ward/coordinating nurses to appoint from among their staff a person to secure the “Covid” sections

presented the scheme of transfers of nurses from December 1, 2020

November 30 – Information from the Director about the possibility of transmitting to the Head of the Registry Office the Death Certificate in the form of an electronic document

December 8 – Communication of the Prime Minister – announcement by the Government of the National Vaccination Programme

December 14 – Announcement from NFZ Headquarters – announcement of a list of hospitals that perform vaccinations for the staff of medical institutions

December 21 – Regulation of the Council of Ministers of December 21, 2020 on the establishment of certain restrictions, orders, and prohibitions in connection with the occurrence of an epidemic state: – removal of quarantine obligation for vaccinated persons; removal of restrictions for vaccinated persons when using care and treatment facilities

December 30 – Communication from the Minister of Health on Comirnaty – concentrates for the preparation of mRNA (messenger RNA) vaccine against COVID-19:

recommendation one vial allows the preparation of five doses,

the product is administered intramuscularly after dilution of the vial as a series of two doses 21 days apart

the dose to the patient is 0.3 ml

vial contains 5 doses with a possibility of up to seven doses

inject 1.8 ml NaCL0.9% into the vial

do not combine residual doses from two different vials

December 2 – Management order 166/2020 of December 2, 2020 on taking measures to increase the hospital's preparedness for an increase in hospitalizations related to SARS-CoV-2 infection

the role of hospital coordinator for “Covid” wards has been established

a scheme was prepared for the activation of additional posts with access to oxygen

an obligation was introduced to provide practical training to physicians on providing medical services to patients infected with SARS-CoV-2

December 11 – Information from the Director dated December 11, 2020 on the designation of the hospital as a vaccination point for personnel of medical entities performing therapeutic activities (nodal hospital): – It was recommended to prepare a preliminary list of those willing to be vaccinated against COVID

December 18 – Information from the Director regarding the suspension of the operation of the Pediatric and the Internal Medicine Wards due to the confirmation of SARS-CoV-2 infection among patients and staff of these wards

December 21 – Order No. 178/2020 of December 21, 2020 on the appointment of the COVID-19 vaccination coordinator

December 29 – Information from the Director concerning the dates of vaccination against COVID-19 for employees of the Hospital