2017 Disbursements

Your Donations At Work

From August 1, 2016 to July 31, 2017 Jim Pattison Children’s Hospital Foundation distributed $1,648,569 for current maternal and pediatric needs. In addition, $100,000 was designated for a research chair position in the pediatric department for exceptional emerging researchers and research needs.

Education

Regina & Area

Pediatric Speech Language
PROMPT: Restructuring Oral Muscular Phonetic Targets Conference
The Conference provides a multi-dimensional approach to speech production disorders, which encompasses traditional physical-sensory aspects of motor planning and performance, and aims to include cognitive-linguist and social-emotional aspects of therapy.

Saskatoon & Area

Alvin Buckwold Child Development Centre
Proven & Effective Play Therapy
This workshop educated attendees on how to use play therapy as an incredible method of communication and diagnostics, including how to interpret the ways in which children play, the importance of what they play with/create, and how to interpret their interactions with professionals.

Alvin Buckwold Child Development Centre
If You Can’t Breathe Course
This course educated attendees on how to integrate, cardiopulmonary and postural control strategies in the pediatric populations.

Alvin Buckwold Child Development Centre
School Based Mental Health Conference
This conference supported Alvin Buckwold Child Development Program Social Workers in providing generalized intervention supports for children and families around increasingly complex psychological and mental health concerns that arise from developmental disabilities.

Alvin Buckwold Child Development Centre
Feeding Therapy Course
This course helped the Feeding Team at Alvin Buckwold Child Development Program improve care being provided to children who attend the program.

Alvin Buckwold Child Development Centre
More Than Words Certification
This course educated staff at Alvin Buckwold Child Development Program on how to better work with young children with autism and their families.

Maternal
CAPWHN National Conference
The conference helps provide patients with the most up-to-date, evidence-based nursing care providing tools and strategies to improve the quality of perinatal and women’s health nursing care and safety.  A large component in this year’s conference is breastfeeding and supporting parents.

NICU
Airborne Neonatal & Pediatric Transport Conference
Medical transport of high-risk and critically ill newborns requires skilled personnel and specialized equipment. A significant number of neonates require emergency transfer to a Neonatal Intensive Care Unit. Airborne conferences are uniquely designed, specifically for neonatal and pediatric transport professionals. It provides education on innovative approaches relating to the latest advances in neonatal and pediatric transport from experts around the world.

PICU
Advanced Practices on Child Maltreatment Conference
The conference allows caregivers access to valuable information and techniques in detecting child maltreatment.  In a hospital setting, PICU nurses are among the first to perform a thorough assessment of an injured child, giving an opportunity to observe interaction between family members.

CAPHC Membership
The Canadian Association of Pediatric Health Centres is a recognized leader and advocate for advancing the improvement of healthcare for Canada’s children and youth. The annual membership was purchased by J Jim Pattison Children’s Hospital Foundation.  Key provincial pediatric department heads support it.

CAPHC Conference
The CAPHC Annual Conference is one of the largest meetings of child and youth health service providers in Canada. Delegates from across the country take advantage of the opportunity to network with colleagues, learn from local and Pan-Canadian experts in child and youth health, and participate in exhibits.

Pediatric Trainee Research Fund
The Pediatric Trainee Research Fund to promote and facilitate child health related research. The program is to provide opportunities and mentoring that generates high quality, relevant research results. The research undertaken has prompt and direct impact on improving health. Trainees play integral roles in advancing these and other research agendas.  Jim Pattison Children’s Hospital Foundation supported this initiative in 2013 and 2014.

Visiting Lectureship Program
The Visiting Lectureship Program provides unique opportunities for internationally renowned child health practitioners, research scholars, and educators to visit the Department of Pediatrics. The visiting lecturers will interact with health care providers, trainees, the general public and administrators to impart their knowledge and provide new opportunities for further enhancing child health and family centered care in Saskatchewan fostering new collaborative research alliances.

WEDOC Conference 2017
Joint sponsorship opportunity between Jim Pattison Children’s Hospital Foundation and the Saskatoon Hospital Foundations. The Annual WEDOC Conference brings together healthcare professionals, administrators, and decision makers to discuss issues on ER flow.

Community
The Loft Program
Families in need receive food and gift hampers to help throughout the holiday season.

Equipment

Provincial

Pediatric Transport Team
Heated Humidified High-Flow Nasal Cannula
Heated Humidified High-Flow Nasal Cannula is used to provide non-invasive respiratory support to children across Saskatchewan, delivering oxygen and air in specific measurements to ensure adequate respiratory support to the patient.  This device will be utilized by the Pediatric Transport Team of Saskatchewan to bring a portable Intensive Care Unit to our province’s most vulnerable population.

Pediatric Transport Team
Pediatric Ambulance
Complete with infrared night vision to detect wildlife and a larger gas tank to reduce stops, the new ambulance replaces a previous model, which logged over 360,000kms. The new ambulance features two transport bays to allow the provincial Pediatric Transport Team to safely treat two patients at once. It also comes equipped with four seats so that parents are now able to travel with the medical team. This ambulance was purchased through a partnership between JPCHF, the Sandra Schmirler Foundation, and Synergy 8 Community Builders.

Saskatoon & Area

Maternal
Bladder Scanner
Bladder scanners are used to assess and plan care for new mothers.  Often after deliveries, new mothers have trouble voiding.  When urinary retention persists for an extended period of time, it can lead to irreversible bladder damage.  The bladder scanned determines the amount of urine in the bladder and prevents unnecessary and often frequent catheterizations.  This equipment is used in conjunction with policies and procedures to promote safe, non-invasive care for new moms.

Maternal
Fetal Telemetry Units
Interventions in labour and birth cannot always be avoided, in which case it becomes necessary to monitor the fetus electronically. Although the fetus needs to be monitored in labour, Fetal Telemetry Units mean that the mother doesn’t have to be confined to a bed or restricted by wires or cords.  It is well understood that mothers who move in labour have shorter labours, a better ability to cope with labour main, and less risk of a variety of adverse complications, as well as decreased cost to the healthcare system in nursing hours, cost of medical intervention, and bed occupancy.

Maternal
Fetal Monitors
Fetal Monitors are used to monitor the heart of a baby during pregnancy, labour, and delivery.  It can also be used to check the duration of contractions. These Fetal Monitors will replace the current models, which are past their expected life cycle and need to be replaced.

Maternal
Dopplers on Stands
The Labour and Delivery Unit at RUH in Saskatoon is the Primary Obstetrical Care Unit and is also the northern referral center for patients and families requiring complex obstetrical care. Best practice for patients is to use dopplers with low risk pregnancies to listen to fetal heart rates from the time they present and throughout their labours. This allows patients to move more freely in their labour.

Maternal
4D Ultrasound Probe & Software
Saskatoon is the referral centre in Saskatchewan for comprehensive fetal heart ultrasounds (echocardiograms). A 4D echocardiogram is the standard in evaluation of baby where a heart anomaly is found or suspected. It allows the viewer to see the heart structure in 3D and how the heart contracts and functions, (the fourth dimension is movement over time). A 4D echocardiogram probe will help doctors make diagnoses that are more accurate for fetal patients and their families.

NICU
i-Stat Analyzer
On average, the PICU transport team makes around 500 trips a year, by both road and air. On route, it is necessary to assess the patient frequently, and administer treatment as needed. An i-STAT machine is an easy to use handheld blood analyzer. It measures the amount of oxygen and carbon dioxide in the blood, as well as determining the pH level or acidity. Using an i-STAT during transport accelerates the patient care decision-making process with a system that makes patient-side testing fast, easy, and accurate.

NICU
Crash Carts
When a code blue is alerted, medical teams rush to the patients’ bedside with an emergency/code blue crash cart. These urgent crises require immediate attention. As the seconds tick by, every minute and move matters, any potential delay could be fatal. These carts contain a defibrillator, monitor, IV and lab supplies, as well as instruments, and any medications needed in an emergency. Having these emergency crash carts results in better patient’s outcome and care.

NICU/PICU
AEEG Monitoring System
AEEG aids in the early detection of seizures in high-risk, premature infants – seizures that may be very difficult to clinically recognize. As untreated seizures can cause significant brain injury, early detection will lead to earlier management and improved outcomes.

NICU/PICU
InVos Monitor
The machine protects the brain and vital organs of children. Unique INVOS technology measures oxygen levels in the brain. It enables clinicians to detect subtle changes in blood flow to the brain in order to make timely, critical, life-saving decisions for improved patient outcomes.

Pediatric Head Injury
Transcranial Doppler Ultrasonography
Over 20% of patients admitted to PICU have a new central nervous system injury or a neurologic complication of their critical illness. Being able to assess real-time cerebral blood flow in children with head injuries will provide two major benefits for our patients. First, it will directly influence care management in patients with acute brain injury. Second, it will provide innovative opportunities for research focusing on improving patient outcomes.

PICU
Procedure Cart
Procedure carts are stocked to accommodate specific procedures. They ensure that all equipment and supplies necessary are available at point of care to increase provider efficiency. This enhances patient safety, as all supplies are required without delay and infection control as the cart encloses the supplies.

Respiratory Therapy
Pulmovista 500
The Pulmovista 500 is a non-invasive way to produce a real-time, breath-by-breath look at the ventilation of the patient’s lungs without the use of radiation.  An electrode belt around the patient’s chest gives insight into their ventilation without causing any pain or discomfort to the child. Using the Pulmovista 500 will allow the Pediatric Department to become a leader in Canada when it comes to advanced ventilation and patient care in pediatrics.

 

Patient Care

Provincial

Pediatric Cardiology
CHAMPS Camp 2017
One in every 100 children born in Saskatchewan has a congenital heart defect. Children growing up with a heart defect are often restricted from playing sports and participating in certain exercises and activities. They are often of small stature and have difficulty growing normally. They also often suffer anxiety and mental health issues related to chronic health issues. For the last two years, CHAMPS CAMP summer camp has been developed by a group of dedicated physicians and researchers in partnership with our Foundation.  This summer camp provides a unique opportunity for children with a heart defect across Saskatchewan to learn what they really should and what they really can do.

Regina & Area

Physio Logic DigiPro Digital Thermometer
Used to make accurate assessments of childhood illnesses and infections based on information provided by the parent or caregiver.  Having an accurate temperature of a child during an illness provides the practitioner with valuable information and helps to guide decisions around antibiotic use and teaching in regards to good antibiotic stewardship.

Saskatoon & Area

Normative Database for Pediatric Bone Density
Pediatric bone health may be compromised in a number of ways (genetic disorders, nutritional, medications, diseases) and treatment decisions are significantly impacted by the interpretation and trajectory of bone health status. The current standard of care for assessing bone health is with bone mineral density (BMD) assessments using Dual Energy X-ray Absorptiometry (DXA). This assessment is then compared with an age-specific, sex-specific normative database in order to provide a patient z-score.

MICYRN Partnership
The Maternal Infant Child and Youth Research Network (MICYRN) is a federal not-for-profit, charitable organization that builds capacity for high quality applied health research. It links 20 maternal and child health organizations based at academic health centres in Canada; is affiliated with more than 20 practice-based research networks; provides support to new and emerging teams; and has established strong national and international partnerships. MICYRN is unique in the world for this type of collaborative engagement. Working together in coordinated fashion enables the sharing of innovations and reduces duplication of effort and resource use, which means more funds, can be spent on doing research.

NICU
Premature Anne SimPad Plus Training Manikin
The Premature Anne is a realistically proportioned 25-week preterm infant simulation manikin. It is designed to facilitate training of healthcare professionals in the initiation of proper care and resuscitation techniques for preterm babies.  Premature Anne helps place learners in scenarios that simulate real-life experiences, which can be conducted to enhance and improve cross-functional team communication.

Air Canada Transport Program

Regina & Saskatoon

Playroom Grants
Funds used to enhance pediatric playrooms in Saskatoon and Regina.

 

Jim Pattison Children’s Hospital Capital Disbursements

Opening in late 2019, the new Jim Pattison Children’s Hospital will offer state-of-the-art equipment and facilities for children, mothers, and families from across our province. Centrally located on the University of Saskatchewan campus in Saskatoon, our new children’s hospital will offer neonatal intensive care, pediatric intensive care, and general pediatrics, pediatric emergency and ambulatory services. Maternal services will include labour and delivery, antepartum, and postpartum. The 176-bed facility will provide the highest quality of care and put Saskatchewan at the forefront of research and innovation.

 

Research

“Research Chair” – $100,000 restricted allocated for the initiation of a Pediatric Research Chair.

“Improved Diagnosis of Pediatric Asthma:  Metabolomic Analysis of Urine” – Dr. Darryl Adamko, University of Saskatchewan

Asthma is the most frequent chronic disease of children and the number one reasons for pediatric emergency admissions in Canadian hospitals.  The lung tissues of children with asthma becomes inflamed and treatment often requires anti-inflammatory drugs like inhaled or oral corticosteroids.  Corticosteroids can have a number of unwanted side effects and deciding when to treat or increase the does is difficult for doctors to predict.  This renders control of the asthma less than optimal.  To measure inflammation, one could use a biopsy however; this is potentially dangerous and painful.  Other less invasive teste are available, but they are less accurate and not suited for the average doctor’s office.   Overall, there is an urgent need for a better test especially one that could be used within reach of a typical doctor’s office.  Developing a novel method to measure changes in children with asthma using a urine sample is instrumental.  The lung tissue damage from asthma creates unique markers in the body that can be measured in the urine.  It is believed that measuring these biomarkers in the urine will reflect changes in the disease.  It is suspect that the amount of these urine markers will decrease after the treatment of the diseases.  Ultimately, hope is that the urine test will not only diagnose asthma better than available techniques but will also help to better adjust the amount of medicine a child needs.

“Early Recognition of Neonatal HIE Through Urine Metabolomics and EEG Analysis” – Salah Almubarak, Department of Pediatrics

Hypoxic ischemic encephalopathy (HIE) can be devastating in newborns and has the potential to cause serious long-term disability. Hence, early recognition and introduction of appropriate treatment is crucial. Halting of HIE progression is important in preventing long-term complications. Early application of therapeutic hypothermia has become a standard of care especially within the first 6 hours of life; however, not all cases of neonates with HIE are recognized at an early stage despite intensive clinical monitoring. Often clinical evidence of HIE does not manifest in the first 24 hours of life when interventions are needed. As such, there are too many infants that go on to have severe brain injury (e.g. cerebral palsy). We need a better screening tool to guide earlier diagnosis and prevention of HIE progression. Metabolomics is the study of small molecules created by cell activity. In disease states, cells produce different chemical substances, which can be measured in a human body. Researchers aim to discover novel biological markers by using urine metabolomic analysis and comparing it to neonatal Electroencephalogram (EEG), in order to recognize HIE at early stage from birth and introduce therapeutic hypothermia to improve long-term neonatal outcome.

“The Chronic Pain Network” – Dr. Krista Baerg, Department of Pediatrics, University of Saskatchewan

Chronic pain is common and results in high healthcare utilization and lost productivity.  This network will establish provincial patient registries and national clinical trials collaborative.  The project will develop the infrastructure and momentum required to progress chronic pain research in Saskatchewan.  The opportunity to participate in clinical trials will enable patients to access new treatments while treating those patients appropriately and safety.  Many partnerships will exist nationally, provincially, within health regions and universities. This is a national collaborative spearheaded by internationally respected pain researchers.

“Indigenous Women’s Perspectives for Culturally Secure Birth Practices” – Angela Bowen, University of Saskatchewan

Indigenous women’s perspective for culturally secure birthing practices is a participatory research project that engages women in an Indigenous Women’s Birth Network to increase our understanding of culturally secure birth. The network will support women sharing their individual stories about their baby’s birth, participating in a talking circle, interpreting the study findings, and developing a photo/voice learning resource to increase the cultural competence and humility of care providers involved in maternity care. The project aims to enhance the maternal healthcare of Indigenous women that will in turn impact the health of the child and growing family.

“CHAMPS: Children’s Healthy-Heart and Activity Monitoring Program in Saskatchewan” – Tim Bradley, Department of Pediatrics

Congenital heart defects are one of the leading types of birth anomaly. Affected children can have abnormal arterial growth and development before and after birth producing increased stiffness of the arterial wall, a well-established risk factor for early onset of adult cardiovascular diseases like heart attacks and strokes. These children can also be of smaller stature, less physically active and at risk for mental health issues. Currently, no chronic disease management program addresses these health needs of the approximately 2400 affected children across Saskatchewan.

Building on previous work funded by Jim Pattison Children’s Hospital Foundation, more affected children are being recruited and their cardiovascular health, body composition, physical activity levels and psychological health will be monitored over the next 3 years. Baseline comprehensive assessments are performed in conjunction with an annual summer camp and compared to data from healthy age- and sex-matched children. Baseline testing includes basic heart, blood vessel and exercise measures to assess cardiovascular health; scans to assess body composition, bone and muscle health; interviews and accelerometry to assess physical activity levels; and questionnaires to assess psychological health. Annual re-testing will then be performed in conjunction with regular clinical follow-up visits. Our long-term goals are to identify which of these children will most benefit from exercise and lifestyle interventions as they transition into adulthood.

This project will be the first of its kind to provide comprehensive long-term monitoring of the physical and psychological health of these children. This new and innovative program tailored to each individual affected child’s health concerns, could then be used as a model to develop a Canada-wide chronic disease management program for children with congenital heart defects to optimize their growth, psychological and long-term cardiovascular health.

“Lactation Expression: Mothers’ Experiences, Information Needs, and Recommendations” – Marie Dietrich Leurer, University of Saskatchewan

Despite the well-known benefits of breastfeeding for both mother and infant, the majority of infants in Saskatchewan are not exclusively breastfed for six months as recommended by the World Health Organization. Women experience various challenges with breastfeeding, which may result in ending breastfeeding sooner than they desire. Breastmilk expression (e.g. pumping, hand expression) is an increasingly common practice among mothers to address challenges with breastfeeding and promote personal lifestyle choices. Little is known about the impact of expression on how long mothers breastfeed. In previous research studies, mothers identified a lack of knowledge related to the expression of breastmilk, and a need for more information and direction from health care providers (e.g. doctors, registered nurses). This research project will interview mothers in the Prince Albert area and Regina Qu’Appelle area to explore their thoughts about: (a) the impact of expression on the length of breastfeeding, (b) frequency, timing and method of expression, (c) mothers’ experiences with health care providers (e.g. helpful advice received and outstanding information gaps), and (d) recommendations for the health care system and other mothers. The findings will provide guidance to health care providers delivering breastfeeding education and support with the long-term goal of increasing the length of time that mothers’ breastfeed in Saskatchewan.

“Cannabidiol in Children with Refractory Epileptic Encephalopathy: A Phase 1 Open Label Dose Escalation Study” – Richard J. Huntsman, University of Saskatchewan

Epileptic Encephalopathy Syndromes seizures are very difficult to control despite patients being placed on multiple medications.  Since treatments often cause significant side effects there is a need to find therapies that are effective and better tolerated for children.

There has been significant media interest regarding medical marijuana products for the treatment of seizures in children.  Hemp oil products with high cannabidiol and low tetrahydrocannabinol ratios have been reported to provide seizure relief and cognitive improvement in children who take them.  Parents have asked for these products to treat their children but due to lack of clinical information, physicians are often reluctant to prescribe.  Parents desperate to treat do so on own and may harm the child.  There is an urgent need to advance research on this treatment option.  This study is to assess the safety and tolerability of a Health Canada approved high CBD: low THC product in children with refractor Epileptic Encephalopathy.  Children enrolled will be monitored for quality of life and seizure frequency

“PRE-GAIN Bone Health Pilot Study” – Munier Nour, Department of Pediatrics

Anorexia nervosa is a condition of severe low body weight. It often occurs in adolescence at a critical time for bone development. Adolescent females with anorexia nervosa are well known to be at risk for bone loss and bone fragility (osteoporosis). This is a result of a number of hormonal changes that occur in response to inadequate nutritional intake. Estrogen deficiency is thought to be a major contributor to the bone loss. Unfortunately, most studies that have attempted to replace estrogen in pill format in those with anorexia have not shown benefits to bone health. Recent developments to replace estrogen through topical application (transdermal) have shown promising results for bone health. Currently, no proven treatment or prevention therapy has been approved for optimizing bone health in young females with anorexia and new, effective strategies are desperately needed.

This study will assess bone health in 24 Saskatchewan adolescent females aged 12-20 years old with anorexia nervosa. Half will receive the topical estrogen. All participants will have their bone health assessed at the beginning of the study and at four other times over a 24-month period. Participants will fill out questionnaires and complete a bone density scan, spine x-rays, blood tests and new state of the art high resolution bone imaging techniques.

Through this study, we will gain a greater understanding of bone health in girls with anorexia. Additionally, this study may provide evidence for future therapies.

“Connected to Care: Uniting Patients, Families, and Practitioners Through a Plan of Care Portal for the Children’s Hospital of SK” – Tracie Risling, University of Saskatchewan

Hospital stays can be very overwhelming for both children and their family caregivers. Surroundings are unfamiliar; there are many members of the care team and a lot of information to try to remember. Research has shown that having access to information can help patients and caregivers feel more engaged in care, be more active in decision-making, and in general feel more satisfied with the hospital experience. Electronic patient portals are a new way to provide this essential information directly to patients or caregivers. These portals can be accessed on a tablet or other mobile device and can be very effective in influencing engagement and communication with the care team. Research has been done on patient portals with adult participants but the use of this technology for pediatric patients is very new.

This project will give families an opportunity to work in collaboration with the research team, healthcare practitioners, and software developers to create a new Plan of Care Portal (POCP) designed specifically for the Children’s Hospital of Saskatchewan. The research project is planned for three years, and will be done in three phases. Family caregivers and healthcare practitioners will contribute their ideas to the design of the POCP in the first phase of the project. Next, technology experts in the health region and project software developers will work to build and test the POCP. In the final phase, the research team will partner with nurses and family caregivers to evaluate the POCP over a six-month pilot period in the acute care setting. Select nurses will have tablet devices to offer the caregivers of patients under their care. If they choose to participate, the caregivers will use the portal and answer survey questions about the experience. Data logged during portal use will also help complete the evaluation.

“Intrauterine Inflammation as a Determinant of Pregnancy Outcome and Child Health” – Alan Rosenberg, Department of Pediatrics

The goal of this research is to improve understanding of the earliest origins of chronic diseases by studying how inflammation occurring during pregnancy can affect the occurrence of diseases in the child after birth.

Chronic diseases in Canada and in Saskatchewan are major burdens for affected patients, their families, and society. Prematurity; obesity and obesity-related diseases, including diabetes and cardiovascular disease; asthma; bone and joint diseases; and nervous system disorders represent major health burdens. There is strong evidence that inflammation occurring during pregnancy can contribute to diseases developing later in the offspring’s life. In this study, we will identify factors in pregnant women, including blood markers and genetic characteristics that appear when inflammation is present. Having a panel of tests to detect inflammation during pregnancy will allow us to then study how inflammation during pregnancy is associated with premature birth, impaired development of the nervous system, obesity, diabetes, cardiovascular disease, reduced bone quality, and respiratory conditions such as asthma.

With this research, our Saskatchewan team will be able to lead Canadian and international collaborations to investigate how genetics, lifestyle factors (such as nutrition, physical activity and reduced stress) and avoiding certain environmental exposures can help reduce inflammation during pregnancy to prevent disease and ensure healthy children now and into their long-term futures.

“Randomized Controlled Trial of the Internet-delivered Preoperative Preparation Program (I-PPP)” – Kristi Wright, University of Regina

Thousands of children have surgery every year, and for many children this is a stressful experience. For example children may cry, kick, or even screaming during this experience and these behaviours are related to negative outcomes such as prolonging induction of anesthesia as well as difficulties following surgery (e.g., separation anxiety, bed wetting). Surgical preparation programs prior to day of surgery are one approach employed to help children who are having an upcoming surgery and their families. However, well-designed, thorough programs have not been well integrated into hospital practice, which may be due to their high costs and low feasibility. Using the Internet as a way prepare children for an upcoming surgery may be an attractive option to address the existing concerns with traditionally delivered programs (i.e., expensive). Specifically, using the Internet as a method to prepare children for surgery would make the preparation widely accessible to parents and children would decrease having to visit the hospital prior to the day of surgery, is relatively inexpensive, and has little impact on the busy day surgery setting. To address this need, we designed an interactive, Internet-delivered preoperative preparation program for both child and parent. The present study proposes to evaluate this accessible approach for the preparation of children (3-10 years old) for surgery. Children will be randomly assigned to receive

treatment-as-usual, access to an Internet preparation program, or access to an Internet preparation program and also have a parent present during the anesthetic induction process. It is anticipated that children in the Internet preparation groups and their parents will have significantly less worries than the treatment as usual group during the day surgery experience, particularly during the most stressful time point (i.e., anesthetic induction). It is anticipated that our innovative approach to surgery preparation will aid in reducing both child and parent worries during the during the day surgery experience and overall improve our ability to provide the best care possible for children undergoing day surgery and their families at the Royal University Hospital

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