Monthly Archives: February 2014

Recent Nursing Promotions Announced

Mandy Bounds, RN

Mandy Bounds, MSN, RN, CCRN-CMC

Editor’s Note: COMPASS is a bit behind in sharing news of recent nursing promotions — here are three and more will be shared in next week’s edition.

Mandy Bounds, MSN, RN, CCRN-CMC has been named Nurse Manager of Critical Care and 2 East Multispecialty Units for University of Maryland Shore Medical Center at Dorchester. In this capacity, she manages the Medical Center’s  16-bed critical care unit and 30-bed medical-surgical unit at Dorchester.

Prior to assuming her new position in December, Bounds  was a Community Case Specialist with Shore Wellness Partners and also had served for three years as Clinical Coordinator in the Critical Care Unit at UMSMC at Dorchester. Now an adjunct faculty member for Wilmington University RN-BSN and BSN-MSN program, she also served as a part-time clinical instructor for Chesapeake College. She is a member of The American Association of Critical Care Nurses (AACCN) and serves as Treasurer of the Delmarva Chapter of the AACN.

Stacey Kram, RN

Stacey Kram, MS, RN,CCRN, PCCN

Stacey Kram, MS, RN, CCRN, PCCN has begun her new position as Nurse Manager of the Critical Care University/Graduate University and Resuscitation Coordinator for UM Shore Regional Health. Formerly the Clinical Specialist at the University of Maryland Shore Medical Center at Dorchester, Kram  has provided direct clinical and education support for UMSMC at Dorchester; participated on multiple system-wide committees and workgroups, including the UM Shore Regional Health CPOE Implementation Team; provided mentorship for new nurse clinical educators; and conducted literature searches and provided comprehensive review for policy creation, review and inclusion of evidence-based practice. Additionally, she has served as a Relief Administrative Supervisor in Nursing and as a member of the adjunct clinical faculty at Chesapeake College. Kram is pursuing a Doctorate of Nursing Practice at Salisbury University.

Renee Edsall, MSN, CC-RN

Renee Edsall, MSN, RN, CC-RN

Renee Edsall, MSN, RN, CCRN is now serving as Emergency Services Educator for University of Maryland Shore Medical Centers at Dorchester and Easton, and for the University of Maryland Shore Emergency Center at Queenstown. Appointed to the position in late 2013, Edsall brings years of experience in roles such as Clinical Nurse Specialist, Staff Nurse, Nursing Faculty Member/Instructor and Research Specialist to her leadership role in Emergency Services Education.

Prior to assuming her new role, Edsall served UM Shore Regional Health as a Staff Nurse in the Emergency Departments of UMSMC at Easton and Dorchester for a total of seven years, and was a Staff Nurse in the Intensive Care Unit at UMSMC at Easton for 11 years. Other positions she has held include Clinical Nurse Specialist at UMSMC at Dorchester and Research Specialist at UMSMC at Easton. She was honored as Employee of the Year 2010.

Edsall’s experience also includes three years as a full-time nursing instructor at Chesapeake College. She is a member of The American Association of Critical Care Nurses (AACN), the Delmarva Chapter of AACN, and the Emergency Nurses’ Association.





Thomas Hired as Regional Manager of Provider Referral and Business Development

Judy A. Thomas

Judy A. Thomas

Judy A. Thomas has joined University of Maryland Shore Regional Health’s Outreach and Business Development Department as Regional Manager of Provider Referral and Business Development.  In this role, Thomas serves as the physician relationship and business development team member for the region, bridging information and customer service needs between UM Shore Regional Health’s services, specialists and primary care providers, both affiliated and community-based.

Thomas has been in health care management in the Baltimore-Washington area for over 20 years.  From 2008 to 2013, she was Executive Director at Bon Secours Baltimore Health System, where she was responsible for the Physician Services Department and the Renal and Behavioral Health service lines. During this time, she focused on the development of a compliant comprehensive physician services department, physician strategic planning and implementation, service line management and development, and integrating health services.

A graduate of American University in Washington, D.C., Thomas is enrolled in University of Maryland University College’s MBA program.

Robin Hood Shop to Celebrate 57th Birthday

Birthday EventThe Robin Hood Shop, located at 416 High Street in Cambridge, will be celebrating its 57th birthday with a Birthday Event on Tuesday, March 18th from 9am-4pm. Pictured with new spring and summer merchandise available for purchase at the event are Robin Hood Shop volunteers, (from left to right) Normalee Cusick, Lucy Willey, Jo Ann Dixon, Helen Travers and Debbie Thomas.   

The shop, operated by the Dorchester General Hospital Auxiliary, is open Monday through Friday from 9am to 4pm, and Saturdays from 10am to 2pm.  For more information about the Robin Hood Shop’s 57th Birthday Event or volunteer opportunities, call (410)228-6339.

DCPS Personnel Visit UMSMC at Dorchester

Dorchester County Public Schools teachers and administrators participating in the  “Americans for Competitive Enterprise Systems” (ACES) program spent this past Monday evening at University of Maryland Shore Medical Center at Dorchester, touring the hospital and enjoying dinner presentations by John Mistrangelo, ACSW, LCSW-C, Program Administrator forthe recently renovated and expanded Behavioral Health Unit, and Trena Williamson, Regional Director of Communications and Marketing for UM Shore Regional Health.

The ACES program, which helps educators learn more about the business, nonprofit and government organizations in Dorchester County, is sponsored by the Dorchester County Chamber of Commerce. This year’s participants who attended the session at UMSMC at Dorchester were most interested in learning how the health care needs of the Mid-Shore population are better accommodated through the affiliation with University of Maryland Medical System, and what kinds of career opportunities today’s students can look forward to as advances in information and medical technology transform health care.

Participants included: Dirk Bayer, Cynthia Collins, Sheila North, and Dan Rice of Cambridge-South Dorchester High School; Sarah Childress, Sarah Tomey and Stephen Williams of Maces Lane Middle School; Renee Hesson  and Kermit Hynes of the DCPS Central Office; and Stacey Smith , Hurlock Elementary School.

Special thanks to John Mistrangelo, ACSW, LCSW-C

Audrey West, Human Resources Coordinator, and Sandy Nibblett of UMSMC at Dorchester Food Services for their assistance in creating this successful showcase event. Through a similar project offered by Talbot County Chamber of Commerce, a group from Talbot County Public Schools will be coming to University of Maryland Shore Medical Center at Easton on March 19.


Documentary Film on Recovery from Addiction Packs The Avalon

Shore Behavioral Health's Sharon Dundon, CAC-AD, right, with her daughter Alexandra, at the film screening. Dundon leads the Recovery for Shore group, Alexandra  a student intern.

Shore Behavioral Health Addiction Specialist Sharon Dundon, CAC-AD, right, with her daughter Alexandra, at the film screening. Dundon leads the Recovery for Shore group, Alexandra is student intern and created the program for the event.

On Wednesday, February 26, The Avalon Theatre in Easton was just about full, upstairs and down, by the time the lights went down for the screening of “The Anonymous People,” the landmark documentary film about the 23.5 million Americans living in long-term recovery and the emerging public recovery movement. The screening was the first initiative of  a newly-formed advocacy and planning group, “Recovery for Shore,” which includes representatives from a variety of Mid-Shore social service, health, mental health, business and nonprofit organizations as well as concerned citizens.

“The Anonymous People” features interviews with more than 30 people who are among the millions in long-term recovery from drug and alcohol addiction and who made the courageous decision to speak publicly.  Appearing in the film are an award-winning actress, a former NBA star, a former Miss USA, a veteran news anchor, a former member of the U.S Congress and many others.  These individuals and others have “come out” to help counter prevailing negative public attitudes toward the process of recovery and individuals engaged in it. The film questions why the U.S. has criminalized and given superficial treatment to a chronic illness that has an annual price tag of $350 billion.

Dr. David Hill spoke after the screening to support the film's call for those in long-term recovery to speak out and advocate for more funding, resources and programs to support persons seeking to recover from alcohol and/or drug addiction.

Dr. David Hill spoke after the screening to support the film’s call for those in long-term recovery to speak out and advocate for more funding, resources and programs to support persons seeking to recover from alcohol and/or drug addiction.

The conclusion of the film brought resounding applause, as did the remarks  following, offered by Dr. David Hill, who described the value that his own participation in long-term recovery has brought to his life and endorsed the film’s call for action and advocacy by others for whom recovery has been a life-changing process.

The screening was sponsored by University of Maryland Shore Regional Health, Talbot Partnership for Alcohol and Other Drug Prevention, Talbot County Prevention Program, Mid-Shore Mental Health, Talbot County Department of Social Services, Rise Up Coffee, Washington Street Pub, Warwick Manor and Recovery for Shore.

According to Sharon Dundon, CAC-AD, Addiction Specialist for UM Shore Regional Health and a key player on the Recovery For Shore steering committee, bringing this widely-heralded film to the Mid-Shore region served to educate and inspire the nearly 400 people in attendance about the need to increase awareness and advocate for programs that support recovery from alcohol and other drug addiction. The group is now planning activities for the Spring, including a possible screening of the film in Chestertown, where several community residents have expressed interest.

More information about Recovery for Shore and how to get involved may be obtained by visiting the Recovery for Shore Facebook Page or contacting Dundon, 410-822-1000, ext. 5452.

“Ask the Expert” Series Reaches Out to the Community in April and May

UM Shore Regional Health will once again hold its “Ask the Expert” series featuring informative presentations to the community given by Shore Regional’s medical staff and expert clinicians. For the spring series, more than a dozen of these discussions, on a variety of health care subjects, will be held throughout the five-county region in April and May. Look here in the coming weeks for the full schedule.

Our thanks to those who are involved in “Ask the Expert” as it reinforces UM Shore Regional Health’s dedication to the health and well-being of the Mid-Shore community.

Staff members who couldn’t schedule the time for this series will have the chance again as we begin preparing for our fall series.  If you have an idea for a future “Ask the Expert” presentation, contact Gregg Bortz in Corporate Communications and Marketing at for more information.

Knotts, Helmer and LeMieux Named February Employees of the Month

   Tim Knotts, Jenapher “Kylie” Helmer, and Jeannine Lemieux, RN are February Employees of the Month.

Tim Knotts, Jenapher “Kylie” Helmer, and Jeannine LeMieux, RN are February Employees of the Month.

Tim Knotts,  Jenapher “Kylie” Helmer, and Jeannine LeMieux share honors as February Employees of the Month.

Knotts, a Medical Technologist Practitioner at University of Maryland Shore Medical Center at Easton, came to the rescue during a severe weather event. The morning-shift phlebotomy staff had been delayed in getting to work. Knotts, who is a hematology tech but had been trained in phlebotomy, volunteered to help with blood collection. He helped draw blood on the 2nd floor  so that the morning labs would proceed on schedule in spite of the staff shortage. His consideration of the patients needing to have lab results in order to have quality care in a timely manner prompted Knotts to help his co-workers to get the job done, and his help was greatly appreciated!

Kylie Helmer, an Imaging Assistant at UM Shore Medical Center at Dorchester, excels at her job by always looking ahead to what can be done to help others around her, including helping her counterparts at Dorchester and also UM Shore Medical Center at Easton.  Her exceptionally positive and caring attitude combine for great skill in patient care– she will do whatever it takes to make the patient comfortable. Her co-workers observed that in spite of her relatively young age, Helmer takes pride in her job and hopes to become a registered technologist one day.

Jeannine LeMieux, RN is a dedicated team member of UM Shore Medical Center at Dorchester’s Critical Care Unit. She is caring and respectful to all patients and families. She goes above and beyond to make her patients and families feel special. She is dedicated to her peers and willingly works extra shifts and exchanges shifts to help the unit. She is committed to excellence and to the profession of nursing. Jeannine is currently pursuing her BSN and has achieved Level III status on the nursing clinical ladder. She is also the unit’s quality champion and makes it her job to ensure the unit provides top quality patient care.

Congratulations, Tim, Kylie and Jeannine on  your selection as February Employees of the Month.

Calendar of Events – March 1 through April 4, 2014

Labor and Delivery I, II & III — Saturday, March 1, 8:30am-3pm, UMSMC at Easton, Nick Rajacich Health Education Center. Overview of pregnancy and birth for expectant mothers, spouses and birthing coaches. Registration: 410-822-1000, ext. 5200.

For Your Health: Identifying and Treating Sleep Problems — Monday, March 1, 8am, WCEI Radio 96.7FM, live interview of Bilal Saulat, M.D., Director, UM Shore Regional Health’s Sleep Disorders Center, in recognition of National Sleep Awareness Week. 

Diabetes Self-Management Class/Easton — Two sessions: Tuesdays, March 4, 18 & 25, 9am-12noon; and Wednesdays, March 5, 12 & 19,1:30-4:30pm, UM Diabetes and Endocrinology Center, UMSMC at Easton. Detailed medical information and strategies enabling patients to manage their diabetes for optimal wellness. Regarding cost/insurance coverage, and registration, contact: 410-822-1000, ext. 5757.

Breastfeeding Support Group — Tuesday, March 4, 10-11:30am, UMSMC at Easton, Requard Center for Acute Rehabilitation, Social Center. Led by lactation consultants. Expectant and new mothers welcome. Free. Registration: Carol Leonard, RNC, IBCLC, RLC, ext. 5535 or 5700.

$6 Sale — Wednesday, March 5, 9am-4pm and Thursday, March 6, 7am-2pm, UM Shore Medical Center at Dorchester. Sponsored by the Dorchester General Hospital Auxiliary.

Mid-Shore Stroke Support Group Meeting — Thursday, March 6, 1-2:30pm, Presbyterian Church, 617 N. Washington Street, Easton. Topic: “For Your Health: Identifying and Treating Sleep Problems,” presented by Bilal Saulat, M.D., Director, UM Shore Regional Health’s Sleep Disorders Center. Contact: 410-822-1000, ext. 5068.

Gestational Diabetes Classes — Thursdays, March 6, 13, 20 or 27, 10am-12noon, UM Center for Diabetes and Endocrinology, UMSMC at Easton. Single-session class addressing gestational diabetes issues, including care during pregnancy and what to expect afterward. To attend, a referral from the PCP or OB provider is required. Free. Contact: 410-822-1000, ext. 5195.

CARES Cancer Patient Support Group — Thursday, March 6 and Thursday, March 20, 5-7pm, UM Shore Regional Health’s Cancer Center. Free. Contact: 443-254-5940.

US TOO Prostate Cancer Support Group/Easton — Tuesday, March 11, UM Shore Regional Health’s Cancer Center. Education and support network providing men and their families with information, resources and peer support relative to detection, treatment options and ongoing survivorship.  Free. Contact: Sharon Richter, RN, 410-820-6800, ext. 2300.

Sleep Talk: For People with Sleep Apnea — Monday, March 13, 4:15-5:45pm, Sleep Disorders Center, UM Shore Medical Pavilion at Queenstown (3rd floor). Learn from professionals about sleep apnea and use of the CPAP treatment; current patients will receive assistance with CPAP fitting and calibration. Hosted by UM Shore Regional Health Sleep Disorders Center and 1st Class Medical, Inc. Free. RSVP required, contact: Meredith Bennett, 410-770-5250 or Rachel Early,

Sleep Talk: For Medical Professionals — Thursday, March 13, 5:45-6:45pm, Sleep Disorders Center, UM Shore Medical Pavilion at Queenstown (3rd floor). An open house for area primary care providers to tour the Sleep Disorders Center, meet the medical and sleep technology staff, review treatment options for sleep apnea, and enjoy refreshments. Hosted by the Sleep Disorders Center and 1st Class Medical, Inc. RSVP required, contact: Meredith Bennett, 410-770-5250 or Rachel Early, 

Uniform Sale — Thursday, March 13 and Friday, March 14, UMSMC at Easton.  Sponsored by the Auxiliary of Memorial Hospital at Easton which raises funds to support programs and services at the Medical Center.

The Best Treatment Goals for COPD — Friday, March 14, 2014 at 1:00 pm, UM Shore Medical Center at Easton, Health Education Center A & B. A presentation by Greg Oliver, M.D., in observance of National Pulmonary Rehab Week. Free, but advance registration required. Contact: 410-800-1000, ext. 5208.

Breastfeeding Class — Saturday, March 15, 9am-12:15pm. Nick Rajacich Health Education Center, UMSMC at Easton. Led by UM Shore Regional Health Lactation Consultants. New and expectant mothers encouraged to attend. Free. Contact: 410-822-1000 or 410-228-5511, ext. 5200.

Look Good… Feel Better — Monday, March 17, 10am-12noon, UM Shore Regional Health’s Cancer Center.  Free ACS program created to help women with cancer look good and improve their self-esteem. Participants get hair, skin and make-up tips, samples and a visit to the Wig Room. Contact: 410-822-1000, ext. 5355.

Prostate Cancer Support Group/Chestertown — Monday, March 17, 7pm, UMSMC at Chestertown, Conference Center. Free. Contact: Chrissy Nelson, RN, CDE410-778-7668, ext. 2175

Diabetes Self-Management Class/Chestertown  — Mondays, March 17, 24, & 31, April 7, 4-6pm. UMSMC at Chestertown, Consult Room. Detailed medical information and strategies enabling patients to manage their diabetes for optimal wellness. Regarding cost/insurance coverage, and registration, contact: Chrissy Nelson, RN, CDE410-778-7668, ext. 2175.

Diabetes Support Group Meeting/Easton — Tuesday March 18, 5:30pm, UM Center for Diabetes and Endocrinology, UMSMC at Easton. Topic: “Controlling Diabetes Burnout.” Free. Contact: 410-822-1000, ext. 5757.

Robin Hood Shop 57th Birthday Event — Tuesday, March 18, 9am-4pm, 416 High Street, Cambridge. The shop is operated by the Dorchester General Hospital Auxiliary. Contact: 410-228-6339.

Low Salties Support Group — Wednesday, March 19, 4-6pm. Shore Wound Care, 503A Dutchman’s Lane, Easton. Topic: Wounds and Diabetes. Contact: 410-820-6500.

CARES Caregivers’ Support Group — Wednesday, March 19, 5-7pm, UM Shore Regional Health’s Cancer Center. Contact: Chelsea Slacum, LGSW, 410-822-1000, ext. 2257.

Safe Sitter Class — Saturday, March 22, 9am-4:30pm, Saturday, UMSMC at Chestertown, Education Center. Teaches youth ages 11-13 the basics of babysitting, including basic first aid, CPR and much more. Taught by pediatric nurses. Cost: $40 per child (scholarships available). Limited space. Registration: Chrissy Nelson, RN, CDE, 410-778-7668, ext. 2175.

Get Relief from Back Pain with Acupuncture and Massage — Monday, March 24, 6pm, Center for Integrative Medicine, 607-B Dutchman’s Lane. Silvia Byerly, acupuncturist, and Stephanie Latham, massage therapist, work together to heal back pain due to accidents, injuries, improper lifting, unhealthy lifestyle and other causes. This free presentation will focus on the benefits of acupuncture and massage in treating back pain. Limited space; RSVP required by March 20. Contact: 410-770-9400.

Cancer Support Group/Chestertown — Monday, March 24, 7pm, UMSMC at Chestertown, Education Center. Contact: Chrissy Nelson, RN, CDE, 410-778-7668, ext. 2175.

Breast Cancer Support Group — Tuesday, March 25, 6-7:30pm, UM Shore Regional Health’s Cancer Center, 509 Idlewild Avenue, Easton. Topic: “Genetic Testing.” Free as part of the Cancer Rehabilitation & Survivorship Program (CARES). Contact:  410-820-6800.

Women Supporting Women Breast Cancer Group — Tuesday, March 25, 6:30pm, Christ Episcopal Church, Cambridge.  Free. Contact: 410-463-0946 or 410-228-3161. 

Diabetes Support Group/Chestertown  — Tuesday, March 25, 6:30pm, UMSMC at Chestertown, Conference Center.  Free. Contact: Chrissy Nelson, RN, CDE, 410-778-7668, ext. 2175.

Bariatric Support Group Meeting — Wednesday, Wednesday, March 26, 3-4pm, Aqua Fit, 818 High Street, Suite 1, Chestertown. Contact:  Mary King, RD, LD, CDE, 410-778-3300, ext. 2295.

When Bad Things Happen: Recovering from Psychological Trauma Through EMDR – Thursday, March 27, 6pm, Center for Integrative Medicine, 607-B Dutchman’s Lane, Easton.  Richard Gibson, LCSW, will explain EMDR (Eye Movement Desensitization and Reprocessing), a treatment that decreases or eliminates, often rapidly, the symptoms of post-traumatic stress. Free; RSVP required. Contact: 410-770-9400.

Uniform Sale — Friday, April 4, 7am-4pm, UM Shore Medical Center at Chestertown Conference Center. Sponsored by UM Chester River Health Foundation to raise funds for equipment for the new Emergency Department.

Strategic Planning Update From the Desk of Ken Kozel, President and CEO

Strategic Planning Update From the Desk of Ken Kozel, President and CEO

As you know, University of Maryland Shore Regional Health began a strategic planning process in November, 2013 to develop a unique set of strategies for the organization to successfully meet the communities’ healthcare needs over the coming three to five years. In the midst of dramatic changes in our external environment — most notably the continued evolution of Maryland’s reimbursement model through the Health Services Cost Review Commission ( HSCRC) and national health reform – change is necessary for Shore to be able to thrive and improve the health of our communities. These changes present challenges and opportunities to health care providers everywhere but there are unique challenges in our rural setting.

Many of you participated in feedback sessions with representatives from Kurt Salmon Associates to provide your ideas and opinions about the needs of our communities and the strengths and opportunities for improvement of our health care organization, now and in the future.  Many more of you, greater than 500 team members, participated in the online strategic planning survey. Thank you to everyone who has participated in and shared ideas for the strategic planning process.

We are pleased to update you on the progress of the Strategic Planning Committee over the past two months.  The last strategic planning update appeared in the December 4 edition of COMPASS.

Since November, the Board’s Strategic Planning Committee has met monthly to review assessments of our market and our internal performance, along with interview themes emerging from feedback sessions with Shore Regional Health team members, physicians and providers, Board and community members, and organizations who work closely with our health system, such as county and state elected officials, county health officers, mental health providers and other community partners.

Much of the external assessment reviewed our current environment – for example, population demographics, use of our services, market competitiveness, financial constraints and overall trends within the health care field. The internal assessment included an in-depth look into our services portfolio, programmatic opportunities and vulnerabilities, and utilization of our resources as well as our performance on quality and patient experience indicators.

These external and internal issues generated the following key considerations for the strategic plan:

  • There is agreement across the organization that a common vision must be established to form the foundation for this strategic plan; defining UMMS’ role in Shore Regional Health’s Strategy will also be equally important.  And the mission, vision and strategies must be communicated with the full organization and the communities.
  • The needs for physician recruitment and retention are paramount for the communities in improving access and in providing quality care.
  • Due to the large and rural nature of the area and sparse pockets of population, access to care will continue to be a challenge for the five-county region; UM Shore Regional Health will have to more closely align with primary care physicians, caregivers, and community partners across the region to bridge gaps in access.
  • The need for our physicians to be increasingly involved and engaged in planning and decision making is critical for our organization.
  • Under the Total Patient Revenue or TPR system, UM Shore Regional Health must operate predominantly as a cost center; maintaining current volumes, market share and associated revenues is essential and, while growth can occur, revenue streams may lag. Understanding the payment system will be important in defining the strategy for the health system.
  • Despite the decline in overall population, there will continue to be demand for healthcare services due to an aging population.  However, the settings in which the care is delivered will undoubtedly vary from what we are familiar with today.  UM Shore Regional Health must determine how to cost effectively use its facilities and capital assets to meet this demand and deliver high quality, coordinated care that improves the health of the population in this region.

On January 25, a group of physicians, board members and management participated in a strategic planning retreat.  The purpose of the retreat was to delve deeper into national trends affecting health care and Shore Regional Health, to review market and internal dynamics described earlier, and to identify and discuss short-term and long term priorities for the organization. On January 28, all members of the medical staff were invited to participate in a strategic planning session with the team from Kurt Salmon Associates who are facilitating this process.  More than 40 physicians provided feedback on the health system’s foundational statements and identified strategic priorities for the organization, particularly regarding physician alignment and primary care access.  We welcome this continued feedback throughout the planning process.

Some of the critical issues that have been highlighted during this process will serve as priority areas for our health system, around which many of our key strategies will be centered:

  • Advancing Quality and  the Patient Experience
  • Improving Physician Alignment
  • Addressing Gaps in Primary Care
  • Addressing Gaps in Current Programs and Overall Service Portfolio
  • Advancing Regionalization
  • Improving Workforce Engagement and Organizational Culture

During the recent retreats and meetings, there has been significant discussion around UM Shore Regional Health’s near and long-term priorities associated with each key issue. In the coming 30 days, the information arising from those discussions will be synthesized into near and long-term strategies for our health system that will be in alignment with UMMS’s strategic priorities.

We are grateful to have received broad support from the organization in this process and have appreciated all the input that you have provided to us and the Kurt Salmon consultants so far.  Based on all the input we have received thus far, we believe that the most important issues have been identified for UM Shore Regional Health and we are well along the way to identifying meaningful strategic next steps to address those issues.  At the end of this process in April, we will have a robust and detailed strategic plan that will provide a strong, positive and thoughtful direction for our health system for the next three to five years.  As the next phase of the planning moves forward, I will continue to keep you informed.