The sudden designation as a COVID-19 Referral Center at the beginning of the pandemic brought about immense change to the Cardiac Catheterization Laboratory (CCL) services of a National Referral Center for tertiary care. As a proactive strategy to determine actions that can be undertaken should an unforeseen event ever happen again, this study was done to explore the impact of COVID-19 to the institution’s CCL caseload, and to review the challenges, innovations and adjustments made by the CCL to become pandemic-capable and crisis-ready.

A qualitative cross-sectional study was conducted, with the first phase describing the CCL census starting from the baseline pre-COVID year of 2019 to the pandemic years of 2020-2022, and the second phase involving Key Informant Interviews (KII) and Focus Group Discussion (FGD) with the hospital and CCL healthcare staff.

The study revealed a large reduction in the urgent, elective and overall number of cases of the CCL in the first year, but has seen a steady increase in subsequent years. Surges of COVID variants were also seen to affect the CCL caseload. The following were noted to be the key elements in the CCL’s transformation to become COVID-19 capable: (a) changes in operations and patient selection, (b) appropriate use of PPE, (c) strict adherence to an infection control protocol, and (d) staffing modifications to reduce infectivity and protect staff availability.

The preparation of the hospital’s CCL to become a pandemic capable laboratory has been difficult and faced many challenges. However, the innovations and adjustments done through efforts and ingenuity of the CCL healthcare team allowed continuous delivery of the highest level of care to patients in spite of the changing pandemic landscape. These changes were duly documented as a basis for response to possible future global and/or national healthcare crises.