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How projects helped the Cayman Islands become COVID-free

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Cayman Islands

For the Cayman Islands’ 60,000 inhabitants, there is currently no need to wear a mask. With no community transmission of COVID-19 in the British Overseas Territory since last summer, they can socialise and enjoy everything the Caribbean paradise has to offer. So how did we achieve this enviable position?

As the global pandemic took hold in 2020, health professionals realised that we could run out of hospital beds within a matter of days. In partnership with the Cayman Islands health services authority, the National Emergency Operations Centre hatched an ambitious plan to create a temporary field hospital to accommodate COVID-19 patients. It would need to be operational within a three-week timescale and capable of being sustained for six months.

Setting up the project

Along with many colleagues, I found myself seconded into the National Emergency Operations Centre. We first identified a local church hall as the best venue for the field hospital, and a matrix-style project team was set up, with an associated cross-discipline sharing culture. This translated into a shared supply chain approach when appointing suppliers and contractors, allowing the designs to incorporate solutions that could later be redeployed across other government assets, in line with a target of 90 per cent of the project works being suitable for reuse.

One innovation was the utilisation of our web-based emergency operations system for lodging business cases that required specific approvals at key project gateways. This meant that a business case generation and approval process that would typically take months was achieved in less than 24 hours.

The processes and procedures that we adopted during the project are now being incorporated into the government’s standard operating approach to ensure the efficiencies in delivery and pace become the new normal. The end product is 90 per cent reusable and provides redeployable assets for the future. The remaining 10 per cent remains with the building for the benefit of the church and for future use should this facility be needed again.

The project was delivered on time, within budget and to the rigorous quality standards required to deliver patient care in a safe way, while also meeting all government procurement requirements. And to cap it all off, the field hospital was recognised by APM, taking home its 2020 Social Project of the Year Award.

Ensuring the beds were never needed

The field hospital project increased our bed capacity by over 40 per cent as an insurance policy. To ensure these beds were never needed, several other projects were coordinated.

A repatriation programme was put in place to ensure returning overseas students, whose schools and universities had closed, could come back safely while minimising the risk of spreading the infection. Over a two-week period, we supported the return of students arriving on 250 different flights, took over the management of local hotels as isolation facilities and provided 24/7 care to keep people safe and secure.

Meanwhile, the need to preserve PPE for our healthcare facilities and professionals was supported by our partners in the Cayman Islands Red Cross, who swung into action to produce thousands of reusable cloth masks for essential workers, including police officers and those on the front line.

Our first case of COVID-19 came from a passenger with a cardiac condition who disembarked from a passing cruise ship. This passenger unfortunately died, and a small outbreak of COVID-19 at a healthcare facility was quickly isolated. This was followed by the introduction of a hard lockdown on all three islands. This tough but decisive action resulted in a break of any residual transmission, and there has been no community transmission of coronavirus since July 2020.

The country’s success thus far means we are decommissioning the field hospital in parallel with our health services authority rolling out the COVID-19 vaccine.

Seven project management tips

Emergency situations do not require a different project management approach, other than perhaps faster decision-making – meanwhile stakeholders do tend to make themselves available more readily.

So, emergency or not, my seven top tips for any project or programme manager are:

  1. Create clarity on what success looks like from the beginning and make sure everyone knows.
  2. Surround yourself with the best people you can, empower them and provide them with the support they need.
  3. Lead the team by reinforcing the end game and help people to take action – words are not enough.
  4. A risk register is a good tool, but accept that things will come up or go wrong and there will be new challenges – that’s why your role has not been automated.
  5. Maintaining relationships with stakeholders and creating an environment of ‘no bad surprises’ is the first step to good governance.
  6. Even in a crisis, don’t forget about sustainability. Doing so will help with governance and help justify the expenditure when the dust settles.
  7. Communicate – do not just transmit information. You need to make sure the information has been received and understood. Keep everyone focused on the daily priorities.

Our most senior leaders recognised the seriousness of this pandemic at an early stage. They listened to advice from officials and directed clear criteria for success. Then they put their trust in the civil service and wider community to deliver. It has been an honour and privilege to have used both my project management and leadership skills to make the Cayman Islands the safest place in the world and be a part of a world-class civil service.

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Image: andy morehouse/


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