The Israel Defense Forces said they are carrying out a "precise and targeted operation against Hamas" in an area in the Al-Shifa Hospital.

"The IDF forces include medical teams and Arabic speakers, who have undergone specified training to prepare for this complex and sensitive environment, with the intent that no harm is caused to the civilians being used by Hamas as human shields," IDF said in a statement.

IDF called upon Hamas militants in the hospital to surrender.

The operation comes after IDF called for military activities in the hospital to "cease within 12 hours," IDF said, adding: "Unfortunately, it did not."

The Israel Defense Forces have informed the Gaza Health Ministry that they will storm the Al-Shifa Hospital in several minutes, Dr. Ashraf al Qadra, spokesman of the Hamas-run Gaza Health Ministry, said on Al-Jazeera TV.

The IDF did not immediately respond to multiple requests for comment on the report.

-ABC News' Nasser Atta

State Department employees have sent multiple internal communications in recent days expressing concerns over the administration’s approach to the Israel-Hamas war, including at least one dissent cable, sources familiar with the matter told ABC News.

The dissent channel is a system that allows diplomats to confidentially register their opposition to specific policies with department leadership, but employees can also formally express their disagreement to high-level officials through other avenues.

State Department spokesperson Matt Miller confirmed Tuesday that Secretary of State Antony Blinken sent a department-wide email on Monday where he noted the tensions and different views among employees.

"He did address in that email...all the issues underlying our policy and made clear people understood what our policy is, just as he has done in meetings he’s had with a number of employees in the department," Miller told reporters.

-ABC News' Shannon Crawford

State Department spokesperson Matthew Miller said Tuesday that just under 1,000 Americans and their family members may be waiting to leave Gaza, as hundreds have left so far through the Rafah border crossing.

"There are now over 600 American citizens and lawful permanent residents and their family members who have departed Gaza through Rafah gate," Miller said during a briefing. "There are a little under 1,000 that we know of that are left now whose departure we hope to facilitate over the coming days should they wish to depart."

The number of eligible individuals who may be looking to leave the enclave is higher than previously anticipated, based on previous State Department figures. Before the Rafah gate opened to outbound traffic, Secretary of State Antony Blinken said some 400 Americans and roughly 600 of their eligible family members were in contact with the department about leaving Gaza.

-ABC News' Shannon K. Crawford

The IDF denied Saturday that it ordered an evacuation of Al-Shifa's patients, claiming the hospital's director requested to allow people in the hospital to leave and that the IDF agreed and offered to assist.

The director of the Hamas-run Gaza Health Ministry -- who said he is leading the exodus of patients -- said in an interview with Al Jazeera that Israel issued the order and that Israel refused to allow ambulances to assist in the evacuation.

The IDF said Saturday it "acceded to the request of the director of the Shifa Hospital to enable additional Gazans who were in the hospital, and would like to evacuate, to do so via the secure route. At no point, did the IDF order the evacuation of patients or medical teams and in fact proposed that any request for medical evacuation will be facilitated by the IDF. Medical personnel will remain in the hospital to support patients who are unable to evacuate."

Lt. Col. Peter Lerner, an IDF spokesperson, denied the IDF had ordered medical staff and patients to evacuate, as well as the the Gaza Health Ministry’s claim that patients had been given an hour to leave, calling it "fake news."

However, another spokesman, Lt. Col Elad Goren, in his evening briefing Friday night said the IDF was urging anyone left in Al-Shifa to leave and that it hoped it would take place in the "next few hours."

Officials and doctors at Al-Shifa hospital say almost all patients and civilians there have been forced to leave the hospital this morning, after Israeli forces gave them one hour to get out.

Dr. Munir Al Barsh, director general from the Gaza Health Ministry, told Al Jazeera, he and hundreds of patients, many seriously injured, were now on the road on foot, making their way south.

He said around 450 patients and wounded had left following the Israeli order. He painted a harrowing picture, saying many patients have open wounds, are missing limbs, some are still in beds and wheelchairs.

According to Al Barsh, around 120 patients who are unable to move are still in the hospital, including the nearly three dozen premature babies. Five medical staff have remained to care for them.

He said the column of hundreds of patients are now trying to make their way to the first hospital they can find on route.

-ABC News' Patrick Reevell