The COVID-19 pandemic is a case of fundamental surprise, a crisis that emerged suddenly, without warning, and which had no preceding pattern. Like most organizations, hospitals were caught off-guard with few to no pre-existing protocols, norms, standards or guidelines in place. Furthermore, public health and institutional leadership did not have enough available information to make informed decisions in the beginning. Hospitals’ management and operations have been challenged with elevated patient volumes; infection prevention; lack of resources; decisions about mode of care-delivery. While there have been multiple challenges, frontline and management staff have adapted to challenging working conditions. There is a need and an opportunity to learn about what has worked during this past year, and to ensure preparedness as hospitals transition beyond the current crisis. The Resilience Engineering Tool to Improve Patient Safety (RETIPS) is a semi-structured self-reporting tool designed to elicit narratives of adaptation in everyday clinical work. The current study tailored RETIPS to the case of a radiology unit to learn from its operational staff about what went well as they adapted to the pandemic. Fifty-eight reports were received between July 29th and October 12th 2020 with over 90% received during the month of August. Participants’ roles included radiology leadership (21%), technologist (19%), nursing (13%), radiologists (10%), and sedation/anesthesia (10%). Participants described examples of lessons-learned, and indicated the success factors, challenges, and resources pertinent to their examples. The thematic analysis of the descriptions of their examples of an ‘adjustment or coping strategy or preventive practice’ identified several prominent themes. The lessons from this experience need to be learned in order to sustain these capabilities going forward, even beyond the pandemic itself.