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Objectives: To compare the effectiveness of four falls risk assessment tools (STRATIFY, Downton, Tullamore, and Tinetti) by using them simultaneously in the same environment.

Design: Prospective, open, observational study.

Setting: Two acute medical wards admitting predominantly older patients.

Participants: One hundred thirty‐five patients, 86 female, mean age±standard deviation 83.8±8.01 (range 56–100).

Measurements: A single clinician prospectively completed the four falls risk assessment tools. The extent of completion and time to complete each tool was recorded. Patients were followed until discharge, noting the occurrence of falls. The sensitivity, specificity, negative predictive accuracy, positive predictive accuracy, and total predictive accuracy were calculated.

Results: The number of patients that the STRATIFY correctly identified (n=90) was significantly higher than the Downton (n=46; P<.001 …