Background: Rhode Island was hard hit by the COVID pandemic due to a particularly toxic combination of demographic factors. It is a densely populated state, with a large immigrant population. The populace is older, poorer, and less educated than the rest of New England. At Kent Hospital, in Warwick, Rhode Island, the first case in [...]

Background: Scholarly productivity is critical for academic fulfilment and promotion in hospital medicine (HM), but many hospitalists struggle to achieve scholarly success. Protected time (PT) (i.e., non-clinical time that can be dedicated to scholarly activities) is a key facilitator of academic productivity in HM. However, little is known about how PT for scholarship is managed [...]

Background: The Acute Care for Elders (ACE) unit is an evidence-based system of acute hospital care starting from admission, designed to maintain or achieve independence and avoid preventable adverse events for older adults. However, little is known about how many ACE units exist and the variety of ways hospitals have implemented this evidence-based clinical model. [...]

Background: Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC). We evaluated whether baseline use of laxatives, including stimulants, osmotic agents, stool softeners, or combinations thereof affects the efficacy and safety of MNTX. Methods: This post hoc analysis included pooled data from 2 multicenter, randomized, double-blind, placebo (PBO)-controlled, institutional review [...]

Background: Several gains have been made against the HIV pandemic, but the menace remains far from over as we continue to encounter it in various clinical situations. HIV infection poses a many-fold challenge in medical therapeutics. By its immunomodulating effect, it creates atypical presentations, makes patients prone to a wide range of infectious etiologies and [...]

Background: With the dramatic increase in the usage of opioids for not only inpatient but also outpatient pain management, a potential increase in opioid-related deaths had led to a national concern regarding opioid usage. The World Health Organization analgesic ladder estimates 90% of the global population will use opioids at least once in their life, [...]

Background: Asthma is one of the most common chronic medical conditions affecting around 300 million people worldwide. It is a disorder of the airways characterized by recurrent symptoms of airway obstruction and inflammation. Invasive mechanical ventilation for patients admitted to the hospital with asthma is challenging with higher complications and higher rates of patient-ventilator asynchrony, [...]

Background: Error reporting is an integral component in the safety program of hospitals. Residents in training programs are encouraged and expected to participate in error reporting as part of the clinical learning environment. Previous studies identified barriers to resident reporting including knowledge of how to submit reports and understanding how reports affect institutional safety culture. [...]

Background: Emergency Department (ED) overcrowding and lack of hospital bed capacity are pervasive problems made worse by the Covid-19 pandemic. Bed capacity is a significant concern at Academic Medical Centers (AMCs), as patients depend upon AMCs for specialized in-hospital care not available at other regional hospitals. Bed capacity shortage is acutely felt at rural AMCs, [...]

Background: Hospitalized patients struggle to recall names and faces of their inpatient physicians. From a survey of nearly 3000 hospitalized patients by Arora et al, only 10% correctly identified one inpatient physician on their primary team (2). This can lead to fractured doctor-patient relationships and decreased patient satisfaction (1). During the COVID pandemic, this issue [...]