Background: As cannabis is legalized/decriminalized in more US jurisdictions, and social norms and perceptions around use change, many products for psychoactive, recreational use, and purported medical uses are available in edible and supplement formats. Rates of unintentional ingestion of cannabis products among children and adolescents have been described in the literature, but there is no [...]

Background: Decision fatigue describes the erosion of decision making capacity as a consequence of the repeated acts of decision making. The phenomenon has been detected in ambulatory settings with higher rates of inappropriate antimicrobial and opiate prescribing and lower rates of cancer screening associated with appointments that occur later in the day. As hospital medicine [...]

Background: Respiratory failure is the most common organ failure syndrome in US hospitals (1). Hospitalists strive to detect the earliest signs of respiratory instability. Measurement of respiratory vital signs (like respiratory rate & oximetry) is a necessary aspect of risk stratification, but it is not sufficient. In one study, 46% of hospitalized patients had no [...]

Background: Hospital at Home programs originated as pilot initiatives on a national scale, gaining momentum during the COVID-19 pandemic. The need for reevaluating healthcare delivery systems became pronounced during this period. Kent Hospital in Rhode Island collaborated with key stakeholders, including Blue Cross Blue Shield of Rhode Island, United Health Care, and CMS, to bring [...]

Background: Sound Hospital Medicine (HM) and Sound Emergency Medicine (EM) staff a 385-bed hospital in California. The Utilization Review (UR) nurses in the ER were not following the hospital’s Utilization Management (UM) Plan of doing initial InterQual reviews before the hospitalist wrote the initial admission order because of the focus on disposition from the ER. [...]