Summary This paper is intended to provide an overview of the Colonial War Memorial Hospital’s response to the Covid-19 pandemic in Fiji. It presents the management and organizational systems and processes developed to ensure effective and timely management of potential COVID-19 cases presenting within CWM. It presents the theoretical model developed to support the Outbreak Management Team in determination of appropriate responses that required to be modified in the light of new knowledge and experience. The paper describes actions taken to ensure the preparedness of CWM; the development of process algorithms required to ensure consistency across the organization; the establishment of an Emergency Management Centre that provides 24 hour oversight of the CWM Covid-19 response; arrangements for quarantine of staff etc. It will also present the Covid-19 Preparedness Assessment Tool that was developed in CWM and subsequently used to assess the state of preparedness at other facilities nationally.