Children’s surgeon highlights concerns over ‘body piercing’ magnet craze

Communications TeamNews

A children’s surgeon is raising awareness of the dangers of magnets after saving the lives of children falling victim to a new ‘body piercing’ craze.

Hull Royal Infirmary’s paediatric surgery department has treated three children who have swallowed high powered ball-bearing magnets in the past three months.

Sanja Besarovic, a consultant paediatric surgeon at Hull University Teaching Hospitals NHS Trust, has written to the Royal Society for the Prevention of Accidents as the latest craze where young people attempt to mimic body piercings sweeps schools.

Ms Besarovic, known to the parents of seriously ill children in East Yorkshire as Miss B, said: “We have seen three cases in the past three months alone and I am concerned about the growing incidence of this problem.

“Parents and schools should be aware of this craze so they can warn children of the life-threatening risks especially if swallowed at different times.

“Most of children are asymptomatic and first symptoms like abdominal pain, nausea, vomiting develop only after damage had been done.”

Consultant paediatric surgeon Sanja Besarovic

It is believed youngsters are attempting to mimic body piercings, unaware that the magnets stick to each other through loops of gastrointestinal tract and could cause bowel perforation or intestinal blockage uf they are swallowed.

Three children, including a four-year-old, were rushed to Hull Royal after swallowing ball magnets. The four-year-old child was lucky to escape injury as the magnets stuck to each other and passed through their digestive system without complications.

However, the two others were admitted to the children’s ward with significant internal damage.

One suffered a perforated stomach and duodenum after swallowing nine ball magnets while another had a small bowel perforation. Both underwent major surgery including a laparotomy and bowel resection.

Ms Besarovic said: “We have been able to save these children but I’m growing increasingly concerned that this is happening more often.

“Both of the children recovered well after surgery but the next child may not be so lucky.”

False nails and blackheads: The ‘medical emergencies’ at Hull Royal’s A&E

Communications TeamNews

People have been turning up at Hull Royal Infirmary’s A&E department to ask emergency staff to remove acrylic nails and squeeze their blackheads.

Hull University Teaching Hospitals NHS Trust is producing a video revealing the non-medical requests from the public as emergency frontline teams come under the toughest winter pressures in recent years.

In the video, nursing staff tell how people have arrived at the emergency care area at Hull Royal Infirmary to ask them to remove false nails and even squeeze blackheads.

Others have turned up in the department with stomach upsets despite the widespread availability of over-the-counter remedies and the risk of spreading the bug throughout the hospital.

Kevin Philips, chief medical officer at the trust, said: “The staff working in our emergency department must be free to deal with people facing life-threatening emergencies.

“However, some of the ‘problems’ staff are asked to deal with are not emergencies or even problems requiring medical attention.

“We are trying our best to cope with the demands of winter as we see increasing numbers of patients with complex health conditions who need to be admitted to hospital.

“We are asking for the public’s help to ensure our staff are there to help those most in need of attention and use alternative services if they do not have a medical emergency.”

The video has been produced as part of the trust’s “A&E: It’s Serious Stuff” advertising campaign to urge the public to use alternative health services such as their GP, pharmacies, minor injuries units and the urgent care centre at Bransholme.

Bus advertising, billboards and posters have been produced with slogans including “Give A&E a break. Not a sprain” and “A&E. That’s emergency care. Not emergency contraceptives”.

Posters are also appearing in pub toilets with the message “Being drunk isn’t an accident. It’s not an emergency either”  in an attempt to persuade drinkers not to visit A&E with hangovers or the effects of excessive alcohol consumption.

Deadline reminder for ‘Baby Footprints’ artwork

Communications TeamNews

Parents have less than two weeks to purchase postcards and prints of their babies’ footprints featured in artwork to mark Hull’s year as City of Culture.

Footprints of babies born in the city throughout 2017 created a unique piece of art now displayed in the foyer of Hull Women and Children’s Hospital.

Postcards were released throughout the year as each of the completed panels was unveiled, with a print of the entire artwork produced last month with limited edition canvases available to order.

Now, Hull University Teaching Hospitals NHS Trust is advising families the closing date to buy postcards, prints or canvases will be on Wednesday, February 28.

Community midwife Sallie Ward with the final panel of the “Born Into a City of Culture” artwork

Sallie Ward, the community midwife who came up with the idea for the artwork, said: “The response to the project has been phenomenal and we’re happy so many families have taken part.

“We don’t want anyone to miss out so we’re again reminding people that they have a limited time left to buy their prints, postcards and canvases.

“We’ve sold more than 3,000 postcards, 1,000 prints and 190 canvases and every penny will be ploughed back into improving maternity services for women.

“As well as knowing they have contributed to a City of Culture project, the families can also take pride in knowing that they have helped the parents of the future.”

The art is now displayed in the foyer of Hull Women and Children’s Hospital

Prints cost £7 each or two for £10. Postcards cost £1 each or £6 for the set of six. Canvases can be ordered for £25 regular size or £50 for a larger one

Postcards and prints can be obtained from the community midwives’ office on the first floor of Hull Women and Children’s Hospital between 9am to 5pm, Monday to Friday.

Canvas enquiries can be made by emailing hyp-tr.hey.baby@nhs.net. Payment is required before an order can take place but people must write “footprints” in the subject line and must send their emails by Wednesday, February 28.

Prints and postcards will also be on sale for the final time at the Hey Baby! Carousel event on Wednesday, February 28, between 6 and 8pm in the foyer of the Women and Children’s Hospital.

Trust offers nursing careers to record numbers of university students

Communications TeamNews

Record numbers of student nurses have been offered careers working for a major teaching hospital in Yorkshire.

Hull University Teaching Hospitals NHS Trust is interviewing 165 student nurses this week as part of its Remarkable People, Extraordinary Place recruitment campaign.

Despite a national shortage of around 40,000 nurses, the trust is on course to hire record numbers of newly qualified nurses in 2018/19 to boost existing staff levels at Hull Royal Infirmary and Castle Hill Hospital.

David Withers, the trust’s head of education, said: “We are interviewing 165 students for adult nursing roles, around 50 more than we interviewed last year.

“Although the majority are from the University of Hull, we’ve also attracted applications from students in Leeds, Lincoln, York, Sheffield, Manchester and Tees-side.

“The response to our recruitment campaign has been phenomenal and we’ve been really impressed by the high standard and calibre of the students who have been selected for interviews.

“People are being attracted to a trust on the up which can offer people fulfilling and rewarding careers, not just jobs.”

Hull students Sharon Sanford, Emma Farr and Sophia Taylor were offered jobs after attending interviews this week.

Emma, 32, worked in a bingo hall before embarking on a three-year nursing degree and has now been offered a job following her successful interview.

She said: “My family is here, I live here and all my student placements have been here so I wanted to work here.

“The whole application process felt easy and relaxed and now that I’ve been offered a job, it’s one less thing for me to worry about.”

Sharon Sanford, 46, was an account manager at KCom before pursuing a career in nursing. She has been offered a nursing post.

“It was a mid-life career crisis for me,” she said. “My children are older so this is the ideal time for me to focus on my career and what I want to do.

“And I want to make a difference.”

Sophia, 22, is aiming for a career in intensive care or cardiac nursing after her successful interview.

“I lost my mother when I was 11 and one significant thing I remember through the bad times was the quality of nursing,” she said. “She had district nurses and spent a long time in Hull Royal and throughout that time, her care was great so that’s why I wanted to become a nurse.

“I’ve grown up here and I think with Hull just being City of Culture, it is an exciting place to work. I feel this trust is going through a period of change and I want to be involved in that.”

As well as rewarding career pathways, the trust will pay bridge fees for students living in the south bank for the first year and offer relocation packages for students living further afield.

(left to right) Trust nurses Lisa Kehoe, Laura Cowan and Rosie Hoyle formed one of the interview panels

Four interview panels featuring nurses already employed at different levels in the trust will conduct the interviews this week, with successful candidates notified within 24 hours.

To take up the job offer, students must submit their dissertation and pass their final exams at the end of their three-year degrees.

They will be hired by the trust as Band 2 health care assistants until they receive their nursing PIN numbers from the Nursing and Midwifery Council, allowing them to familiarise themselves with their new working environment and start earning.

New recruits will benefit from a fully-supported “Let’s Get Started” induction process as they put their academic skills to practical use working alongside fully qualified staff on the wards, theatres and departments.

They will also be offered six-monthly rotations in different specialities to give them the opportunity of experiencing a variety of nursing roles before they choose a particular career route.

Mr Withers said: “Students who join our trust get the added benefit of experiencing a role they may not have considered previously.

“We are supporting our newly qualified nurses from the outset, ensuring they have a package of learning in place to aid their development as they embark on what we hope will be successful and fulfilling careers with the trust.”


Patient tracking issues – Trust statement

Communications TeamNews

In 2017, the Trust identified a cohort of patients who have not been tracked appropriately through its patient administration system, Lorenzo. It is not uncommon for Trusts to experience this kind of issue as a result of any new system implementation.

Around 85,000 patient records in total, some dating back to 2015, were identified as not having tracked properly. Following an initial review of those 85,000 records, a total of 7,433 patients have been identified as requiring further clinical input across various hospital departments. To set this in context, the Trust sees around half a million patients in outpatient clinics alone every year.

Ellen Ryabov, Chief Operating Officer at Hull University Teaching Hospitals NHS Trust, said:

“Earlier this year, we identified a number of patients who had not been appropriately tracked through our patient administration system, prompting a review of those patients’ records.

“For completeness and assurance, we have reviewed records back to the implementation of the new Lorenzo system in 2015. The system itself is not the issue, rather its capabilities have helped us to identify the problem and all of the patients affected by it.

“We are confident that we have now identified all patients whose records had not tracked correctly, and those patients within this group who require further clinical input. To clarify, patients identified as requiring ‘further clinical input’ do not necessarily require medical treatment, but could need any of the following; discharge from the hospital; a results letter being sent to them; adding to a separate waiting list; being seen by a doctor or nurse in clinic; or further tests or treatment.

“The clinical review process, and that of contacting patients who require further clinical input, are both well under way, and these patients are being prioritised as appropriate.

“An investigation seeking to establish how the issue was able to occur will be undertaken in due course, once the review of all patients has been completed and all further clinical input arranged. Our focus and our priority at this stage is on patient care first and foremost.

“We would like to apologise to anyone who has been affected by this issue and remind people that we will be contacting them directly if any further action is required on our part. We would also like to thank those staff who have worked exceptionally hard to validate records in a very short space of time.”

The process for validating (reviewing) records comprises two stages:

  1. Admin validation, whereby Trust staff reviewed each record to ensure that all actions required on the patient’s record had been completed. The admin review of circa 85,000 records has now been completed in its entirety.
  2. Clinical review – following the above review, and where there is no definitive record of a required action being completed for a patient, the relevant consultant is asked to review the patient’s record again to determine what further action now needs to take place. Those considered highest risk and those dating back the furthest have been prioritised for review, and this work is now more than 50% complete. The Trust is working towards an end of March deadline for the completion of all clinical reviews.

The Trust has also established a committee, chaired by the Medical Director, which meets fortnightly to consider any cases where the patients’ conditions may have deteriorated or there is a view that the patient may have come to potential harm as a result of the tracking issues. Duty of Candour is being enacted in all cases where it is appropriate to do so.

 

 

What you need to know about giving birth in water

Communications TeamNews

Choosing to give birth in water can increase relaxation and reduce the need for medical intervention and is used by almost one in three women for pain relief during labour.

All three of the suites in the Fatima Allam Birth Centre in Hull are fitted with birthing pools and there is a pool in the delivery ward of Hull Women and Children’s Hospital.

Now, midwifery sister Suzanna Lascelles is encouraging women to consider water births when weighing up their options.

“Bringing your baby into the world in a birthing pool can be a special experience for new parents,” says Suzanna, who is in charge of the birth centre.

“The warmth and sensation of the water can relax women during labour and help them manage contractions.

“Often, women choose to get into the water in the birthing pools here in the Fatima Allam Birth Centre even if they had not considered this during pregnancy when making birth plans because they are available in the room.”

According to a maternity survey by the Care Quality Commission (CQC), 38 per cent of women planned to use water or a birthing pool during labour in 2015 compared to 34 per cent in 2013.

And the number of women actually birthing their babies in water has trebled in eight years, rising from just three per cent in 2007 to around nine per cent in 2015 while the number of women giving birth to their babies on a bed fell from 91 per cent to under 84 per cent.

To help women consider water births, here are some frequently asked questions.

What are the benefits of using a birthing pool?

Being in the water decreases the effect of gravity and can help women to move around more freely and change into a comfortable position.  Water can help women relax by reducing adrenalin and promoting the release of the body’s natural hormones to cope with labour pains.  Women who use a pool also have a lower rate of medical intervention.

Can I use the birthing pool even if I don’t want to have a water birth?

Yes. The sensation of warm water can help during all stages of labour. You can use water in the bath at home in the early stages before you come into hospital to manage early labour pains and backache.

What should I wear in the water?

Wear what you like. Some people wear a bikini top or a t-shirt.  Others choose to wear nothing.

Can my birth partner get in the pool with me?

Yes, if you want them to.  We just ask that everyone showers first before getting into the water and that swimwear is worn by birth partners.  The three birthing suites at the Fatima Allam Birth centre all have wet rooms equipped with showers.

What should I do once I’m in the water?

You can move around and try different positions when you’re in the birthing pool. You can kneel or lean on the side of the pool, you can squat, holding onto the sides of the pool, you can use floats under your arms for support or you can float on your back with your arms holding the sides and your head supported on a waterproof pillow. You can also float on your stomach with your head turned sideways, resting on a pillow. If your partner is in the water with you, sit with your back against them or with your arms around their neck. There are lots of different options to try out.

Drink plenty of water or juice because you’ll be using up energy and sweating so you’ll need to replace fluids. Drinking through a straw might be easier. But be prepared to empty your bladder regularly during labour so your baby has as much space as possible in your pelvis. You will be encouraged to leave the pool for short toilet breaks while you’re in the birthing pool.

What will the midwife do?

Your midwife will carry out observations on you and your baby to ensure you remain well and safe.  She’ll keep the temperature of the water between 36 ºC and 37.5 ºC at all times.  It’s important not to have the water too warm or you’ll overheat, causing distress to your baby and increased discomfort for you.  The midwife will check your temperature, pulse and blood pressure are within healthy ranges, will monitor your baby and check how often your contractions are coming. Your baby’s heart rate can be monitored while you’re in the water using a water proof hand-held Doppler.

Any questions you have about monitoring in labour can be discussed with your midwife when making your birth plan.

Even if I get in the pool, can I still get pain relief?

Yes, you can still use Entonox – gas and air – while you’re in the birthing pool. However, should you wish to have Pethidine or Meptid, you would need to stay out of the water for two hours after the injection.

In what situation would I need to get out of the pool?

There are clinical reasons why you might be asked to get out of the pool. These are all to do with either you or your baby’s safety. This is one of the reasons the midwife will undertake observations on both you and your baby in labour. The midwife will keep you fully informed of how both you and your baby are during labour.

Can I get in the pool during labour but still give birth ‘on land’?

Yes, of course. Some women are happy to use the birthing pool during labour but want to give birth to their baby out of the water. The choice is yours.

Isn’t it dangerous for my baby to be born under the water?

No. A baby’s breathing reflex only starts when it comes into contact with air.

The reason the midwife will ensure the pool water is kept at a regulated temperature is that being born into water that is the same temperature as your body will not stimulate your baby to breathe.   Your baby will not take its first breath until he or she senses a change in temperature and has the feeling of air on their skin. Your baby will still receive oxygen during this period of time through the umbilical cord.

You or your midwife can bring the baby to the surface of the pool face first as soon as they are born. You can then have skin-to-skin contact with your baby in the pool, with the baby kept warm by keeping their body under the warm water while you cuddle them.

Babies born under water can be calmer following birth than babies born in air and may not cry or move vigorously. This is normal and no reason for worry. Your midwife will carefully observe you and your baby following birth, giving you any guidance and support needed.

Is water suitable for all women in labour?

No, water birth may not be suitable for everyone. There is criteria to be able to use the birth pool and this can be discussed with your midwife.

However, for healthy women who have had an uncomplicated pregnancy, using water has been established as safe.

Women who have any complications in their pregnancy and do not fit the inclusion criteria for the birth centre but would still like to use the birth pool during labour can have that discussion with their named consultant and midwife.

The Labour Ward at Hull Women and Children’s Hospital has its own birthing pool. Women who require care on the obstetric-led ward and whose babies require continuous monitoring in labour may still use the birthing pool with a wireless, waterproof monitor used to monitor the baby’s heart rate continuously through labour.

Where can I find out more information?

You can learn more about the benefits of water births and the use of water in labour from our midwives at the next Carousel event at Hull Women and Children’s Hospital on Wednesday, February 28, between 6pm and 8pm.


Grieving family donate incubator described as ‘next best thing to the womb’

Communications TeamNews

The family of a young man killed in a motorbike accident are donating an incubator described as “the next best thing to the womb” to care for the area’s sickest babies.

Specialist staff at the neonatal intensive care unit (NICU) based in Hull Women and Children’s Hospital will start a trial of the Drager Babyleo incubator this week.

NICU is a regional specialist centre looking after babies born prematurely or with health complications from across Hull, East Yorkshire and Northern Lincolnshire.

Kirsty and Rob Gill decided to raise £18,000 to pay for the incubator in memory of their son Christopher, who was just 20 when he lost his life in an accident in Ottringham in June 2009.

 

Mr Gill said: “This is very sophisticated equipment but it can also save lives. The more people you talk to in life, the more you hear stories about how they’ve had things happen to their babies or their grandchildren.

“We wanted to do something to help and I think Christopher would have been very proud of us.”

To support the baby’s development, the Babyleo incubator has a low operating noise level and low level lighting, reducing the baby’s exposure to potential harmful stimuli.

The mother’s voice or heartbeat can be recorded as part of an integrated audio function to soothe her baby and the height can be adjusted so the parents can sit as close to their baby as possible.

The incubator features a mattress and heaters synchronised to avoid both heat loss and overheating for babies being cared for on the unit.

A quick-release hood also means staff can open the incubator with a single finger and it provides NICU staff with 360-degree access to the baby.

Information on the baby’s condition is displayed as part of a “family view”, enabling parents to understand progress at a glance and help them feel involved in the infant’s care.

Mr Gill, of Keyingham, said the family embarked on the fundraising quest around four years ago after Christopher’s girlfriend Roxy Richardson endured the death of her baby nephew.

“That kick-started everything all off,” he said. “We started with a zumbathon in Hessle and the landlord and staff at the Blue Bell in Keyingham have been absolutely outstanding in their support.

“They have a harvest festival and auction every year which has raised a considerable sum and Darren, the landlord, had completed a Tough Mudder for the fund.”

Sister Kate Lamming, nursing lead for NICU, thanked Christopher’s family for their generosity in providing the equipment which will benefit so many infants.

She said: “The family wanted to provide something that was like a cuddle for the babies because that was something they’d never be able to give Christopher’s children.

“We need advanced technology like this to ensure we are providing the very best treatment available.

“But we wouldn’t be able to afford it without the generosity of families like Christopher’s relatives and friends and through donations to our charity and we are just so grateful for the support we receive from the public.

“Our team already provides the highest standards of care but this incubator will enable us to improve that even further.”


Operation Wintergreen achieves benefits for patients and staff

Communications TeamNews

Fewer patients are facing delays at Hull Royal’s A&E after an eight-day initiative freed up beds and diverted staff to the frontline to cope with winter pressures.

Operation Wintergreen was launched by the trust on Monday, January 29, to reduce delays in A&E and reduce the number of patients with medical conditions who were being sent to surgical wards because of bed pressures.

As the initiative ended at 8am today, figures show almost 87 per cent of patients were seen within four hours during Operation Wintergreen compared to 83 per cent the previous week, with 85 fewer patients waiting longer than four hours.

Fewer medical patients were sent to surgical wards, referred to as medical outliers, during the week, an improvement of more than 31 per cent on the previous week’s figures.

Chief operating officer Ellen Ryabov said: “We set out to reduce the delays facing patients coming to our emergency department and to reduce the number of medical outliers and we have achieved both aims.

“While there has not been a dramatic transformation, Operation Wintergreen has been of benefit to both our patients and our staff.

“Our services remain under intense pressure and we are still seeing very sick patients who require hospital admission.

“We will continue to monitor our performance to ensure we are delivering the best possible patient care.”

Around 600 routine operations and outpatient appointments were cancelled and rescheduled during the eight-day initiative to allow staff and resources to be diverted to patients most in need of emergency treatment.

Mrs Ryabov said: “Cancelling operations and appointments is not something we would do lightly and we apologise to those patients who have been affected.

“I would like to assure them we are working hard to reschedule their appointments and procedures as soon as possible and we thank them for their patience in allowing our resources to be targeted as our sickest patients in most need of our help.”

Dozens of office staff were also released from their normal day jobs to work on wards, assist porters and act as “runners”, collecting notes or samples.

Mrs Ryabov said: “We would like to thank all staff involved in Operation Wintergreen. Every single day, people at this trust go above and beyond their job descriptions to help patients and we appreciate how hard they work, particularly over these past few weeks.

“We are now in a better position than we were before the start of Operation Wintergreen and we are hoping to capitalise on the progress we have made over the coming days.

“We are still under intense pressure and we continue to appeal to the public to only come to A&E with life-threatening emergencies so our frontline teams are free to help the people who need us most.”

‘It’s great to work as a team’: Staff volunteer for Operation Wintergreen

Communications TeamNews

He spends his days working on education programmes to train and enhance the knowledge of doctors working at Hull Royal Infirmary and Castle Hill Hospital.

But, this week, Danny Murphy-Pittock joined the army of volunteers who devoted part of their working day to work on wards and frontline departments facing winter pressures.

Operation Wintergreen was launched by Hull University Teaching Hospitals NHS Trust on Monday to reduce the pressure on both hospitals and ensure patients most in need of emergency care were seen as quickly as possible by staff.

Danny, who works in the trust’s medical education department, was sent to Ward 60, which cares for female surgical patients, to support staff.

He said: “It was my first time volunteering and it was a really good experience.

“I helped out with the paperwork on the ward, helped stock up the trolleys and went down to microbiology to deliver samples and pick up bottles.

“I then went round with the tea trolley and felt like I was actually contributing. I was supported and felt valued by the team on the ward. They made me feel really welcome and appreciated that I was giving up my time to be there.

“When the trust is experiencing difficulties, it is good to work as a team and support staff in other areas.”

Hundreds of staff are taking part in the eight-day initiative, including office and administrative workers who are volunteering on wards or working with porters and pharmacy teams.

Other staff are being redeployed from other areas such as theatres and outpatient clinics to improve the flow of patients through both hospitals.

Michelle Veitch, the trust’s deputy chief operating officer, said: “We are immensely grateful to the volunteers who have stepped forward to help the organisation cope with unprecedented levels of demand.

“We are beginning to see improvements in patient flow, with people spending less time waiting in our emergency department as we have been able to free up more beds around the hospital.

“We are also able to send patients to appropriate wards rather than where there is bed space, which means the patient will have a better hospital experience.”

Operation Wintergreen will run until 8am on Tuesday.

 

Operation Wintergreen ensuring patients are seen more quickly

Communications TeamNews

Patients are being treated more quickly at Hull Royal Infirmary after the launch of a programme to tackle unprecedented winter demand.

Almost 89 per cent of patients were seen, treated, admitted or discharged within four hours between Monday to Wednesday this week compared to 76 per cent over the same period last week, an improvement of 13 percentage points.

Hull University Teaching Hospitals NHS Trust launched Operation Wintergreen on Monday to plough extra staff and resources into wards and departments as it coped with an influx of seriously ill patients over the past five weeks.

Four days into Operation Wintergreen, patients are spending less time waiting in the emergency department and fewer patients with medical illnesses – referred to as medical outliers – are being cared for on surgical wards because of a shortage of beds.

Michelle Veitch, deputy chief operating officer at the trust, said: “We are seeing a reduction in the number of patients outlying in different departments.

“We are also seeing empty beds on the assessment units and it’s an improving picture in terms of capacity.

“This means we have fewer patients in our emergency department waiting for beds on our wards.

“However, we are still facing pressures and I would say we are seeing a gradual rather than a dramatic improvement.”

The trust is reviewing the impact of Operation Wintergreen, due to finish at 8am on Tuesday, on a daily basis.

Pharmacy, catering, portering and support staff have been working extra hours alongside clinical teams to improve patient flow and ensure patients are able to return home as soon as they are well enough.

Around 600 outpatient appointments and routine operations have been cancelled to ensure specialist staff can be redeployed to A&E and the assessment units in an attempt to reduce the number of unnecessary admissions.

Chief operating officer Ellen Ryabov said: “Cancelling appointments and operations is never something we would do lightly and I would like to apologise to those patients who have been affected.

“I would like to assure them that we will be rearranging their appointments and procedures as quickly as possible.

“We needed to take this additional action to support our emergency patients and staff and we believe we will be in a much stronger position at the conclusion of Operation Wintergreen.”