Learning from the first wave: Lessons about managing patient flow and resource utilization on medical wards at providence health during the COVID-19 pandemic.

We report the successful implementation of a modified Traffic Control Bundling (TCB) protocol called "Red, Yellow and Green" on the inpatient medical units at St. Paul's Hospital in Vancouver, Canada during the first wave of the coronavirus disease 2019 (COVID-19) pandemic. The modified TCB protocol demonstrates an important example on how hospitals can rapidly reorganize operational and clinical processes to reallocate existing capacity to minimize exposure, improve traffic flow and reduce nosocomial transmissions of COVID-19 to health care workers (HCWs) and other patients. Preliminary evidence demonstrates the benefits on how an existing facility can be redesigned for adjustable ward capacity to provide disease containment under a context of uncertainty of disease transmission and varying patient load. Important lessons in preparation for the evolution of the pandemic fall into categories of risk management, capacity and demand management.

Crystal structure of catena-poly[[(dimethyl sulfoxide-κO)(pyridine-2,6-di-carboxyl-ato-κ(3) O,N,O')nickel(II)]-µ-pyrazine-κ(2) N:N'].

The title coordination polymer, [Ni(C7H3NO4)(C4H4N2)(C2H6OS)] n , consists of [010] chains composed of Ni(II) ions linked by bis-monodentate-bridging pyrazine mol-ecules. Each of the two crystallographically distinct Ni(II) ions is located on a mirror plane and is additionally coordinated by a dimethyl sulfoxide (DMSO) ligand through the oxygen atom and by a tridentate 2,6-pyridine-di-carb-oxy-lic acid dianion through one of each of the carboxyl-ate oxygen atoms and the pyridine nitro-gen atom, leading to a distorted octa-hedral coordination environment. The title structure exhibits an inter-esting complementarity between coordinative bonding and π-π stacking where the Ni-Ni distance of 7.0296 (4) Šacross bridging pyrazine ligands allows the pyridine moieties on two adjacent chains to inter-digitate at halfway of the Ni-Ni distance, resulting in π-π stacking between pyridine moieties with a centroid-to-plane distance of 3.5148 (2) Å. The double-chain thus formed also exhibits C-H⋯π inter-actions between pyridine C-H groups on one chain and pyrazine mol-ecules on the other chain. As a result, the inter-ior of the double-chain structure is dominated by π-π stacking and C-H⋯ π inter-actions, while the space between the double-chains is occupied by a C-H⋯O hydrogen-bonding network involving DMSO ligands and carboxyl-ate groups located on the exterior of the double-chains. This separation of dissimilar inter-actions in the inter-ior and exterior of the double-chains further stabilizes the crystal structure.