Background: Venous thromboembolism (VTE) is a preventable cause of morbidity and mortality in the hospital setting. While respiratory symptoms are the fundamental feature of COVID-19 infection, VTE is a known sequelae given the hypercoagulable state of the disease. Therefore, it is common for hospitalists to prescribe prophylactic anticoagulation in the inpatient setting for patients with [...]

Background: A robust QI curriculum provides residents with the knowledge of QI methodologies and allows them to participate in a longitudinal QI initiative, demonstrating the skills required to implement, analyze, and present a full PDSA cycle. Limitations to having all residents in a training program be meaningful participants in ambitious QI projects are in large [...]

Background: The ongoing global COVID-19 pandemic has stressed patients, hospital systems, and society and, while treatment modalities are continuously evolving. A phase 3 clinical trial of monoclonal antibody infusion in appropriate patients with Casirivimab and Imbdevimab demonstrated a 70% reduction in hospitalization or all-cause death compared to placebo (ref 1). An emergency use authorization by [...]

Background: The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patient perspectives of hospital care. HCAPS scoring is tied not only to hospital compensation, but also is an important indicator of and reflection of interactions with patients. Specifically at Rhode Island Hospital, the goal [...]

Background: Studies have demonstrated that oral medications such as metformin are safe to continue in the hospital, and that when insulin is used in a hospital setting, a basal or basal-bolus regimen is more effective than sliding scale monotherapy (1-2). Despite mounting evidence and society guidelines, clinicians have been slow to adopt these practices in [...]

Background: Communication related to medications is an important metric on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure patient experience after discharge from the hospital. There are many factors which can lead to poor communication about medications (Figure 1). Over 20% of readmissions can be related to medications, and of [...]

Case Presentation: Patient 1:39 week gestation newborn male with a birth weight of 3521 grams. Prenatal course was overall uncomplicated. Mother was a 27 year old G2P2 woman who had used medical cannabis several times a week during pregnancy for PTSD, anxiety and headaches. No other non-prescribed substances were used and umbilical cord toxicology testing [...]

Case Presentation: A 52-year-old man presented with 3 weeks of intermittent fevers along with 3 days of epigastric pain and black stool in the setting of recent travel to the Poconos, Pennsylvania and Ecuador. While at his vacation home in the Poconos mountains, the patient spent time clearing away brush and ate cooked wild mushrooms [...]

Case Presentation: A 25-year-old male with no significant past medical and family history presented with a one-week history of fever, productive cough, intermittent shortness of breath, diffuse muscle aches and one episode of syncope on the day of presentation. Initial workup in the emergency department was positive for COVID-19. Inflammatory markers, D-dimer and Fibrinogen levels [...]

Case Presentation: A 76 year-old woman with coronary artery disease, hypertension, and chronic kidney disease presented to the ER with a one-day history of profound generalized weakness and acute severe anemia. She had known diverticulosis and was taking aspirin 81 mg twice daily status-post a left total hip arthroplasty three weeks prior. Review of systems [...]