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This sample of older lesbian and bisexual women from WHI shows many of the same health behaviors, demographic, and psychosocial risk factors reported in the literature for their younger counterparts, despite their higher socioeconomic status and access to health care. The lower rates of recommended screening services and higher prevalence of obesity, smoking, alcohol use, and lower intake of fruit and vegetables among these women compared with heterosexual women indicate unmet needs that require effective interactions between care providers and nonheterosexual women.

Resident-centered MDR is an effective process using no additional resources that simultaneously improves quality of care while enhancing resident education and is associated with shortened length of stay.

Interest in nutrition screening has increased rapidly due to regulatory requirements as well as the known adverse impact of nutrition deficits on outcomes of hospitalization. Screening programs now in use in acute care are often complex and difficult to administer. Current interest in evaluation of all aspects of healthcare using evidence-based methods requires that nutrition screening programs be thoroughly evaluated. Clinicians attempting to evaluate evidence in support of different methods to identify patients who might have nutrition problems are often confronted with research that blurs the distinction between screening and assessment. Therefore, before identifying methods to conduct nutrition screening, it is necessary to have a thorough understanding of the difference between screening and assessment. A review of terms, definitions, and programs for screening in other areas of healthcare will provide some guidance to the clinician faced with development, implementation, and monitoring of nutrition screening programs. This facilitates development of nutrition assessment programs so that patients who have a nutrition screen are assessed in a timely fashion and receive appropriate nutrition interventions.

Internal medicine residents demonstrate less regard for patients with SUDs. Participation in a course in addiction medicine was associated with modest attitude improvement; however, other efforts may be necessary to ensure that patients with potentially stigmatized conditions receive optimal care.

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OBJECTIVE:Although hospitalists have been shown to improve both financial and educational outcomes, their ability to manage dual roles as clinicians and educators has been infrequently demonstrated, particularly in the community setting where large numbers of residents train. We evaluated the impact of hospitalists on financial and educational outcomes at a midsized community teaching hospital 1 year after implementation. DESIGN:Two hospitalist clinician educators ( HCEs) were hired to provide inpatient medical care while participating in resident education. Length of stay and cost per case data were calculated for all patients admitted to the hospitalist service during their first year and compared with patients admitted to private physicians. The hospitalists' top 11 discharge diagnoses were individually assessed. For the same time period, categorical medicine residents ( N = 36) were given an anonymous written survey to assess the HCEs' impact on resident education and service. RESULTS:Resource consumption: length of stay was reduced by 20.8% and total cost per case was reduced by 18.4% comparing the HCEs with community-based physicians. Reductions in both length of stay and cost per case were noted for 8 of the 11 most common discharge diagnoses. Resident survey: over 75% of residents responded, with all noting improvement in the quality of attending rounds, bedside teaching, and the overall inpatient experience. Residents' roles as teachers and team leaders were largely unchanged. A driving force behind the expansion of the hospitalist movement is the potential to deliver high-quality medical care while decreasing inpatient costs and improving efficiency. Several institutions have demonstrated that both length of stay (LOS) and cost per case (C/C) have been reduced through the use of hospitalists. CONCLUSION:1-6 On average, hospitalists have been reported to reduce LOS by 16.6% and C/C by 13.4%. 1 Such decreases have been shown in both academic 2,3 and community-based institutions. [4][5][6] Though economic forces ultimately drive the utilization of hospitalists, other outcomes, such as the benefit of hospitalists on the medical education of internal medicine residents and medical students, have been explored to a limited extent. 7 In one large university medical center, residents expressed satisfaction with the teaching provided by hospitalists and reported that it was equivalent and often superior to that of traditional ward attendings. 2 In fact, these residents requested that hospitalists be a part of all of their future inpatient ward rotations. Another university medical center found that the presence of hospitalists improved the quality of attending rounds, increased the emphasis on resident education during inpatient rotations, and enhanced residents' overall learning experience. 8Despite the fact that hospitalists often serve in dual roles as clinicians and educators, there are few data on their ability to effectively manage these roles simultaneously. For academic community-based teaching hospital...