Neurohospitalists represent an emerging neurological subspecialty focusing on inpatient neurological disease. Little data exists regarding neurohospitalist practice information and clinical activity. A survey among neurohospitalists was performed to help define the subspecialty, yield demographic information, practice characteristics, and understand clinical and non-clinical activities. During the formation the Neurohospitalist Section of the American Academy of Neurology September 2008, an online survey (29 questions mixed categorical, numerical, and free text) of 93 neurohospitalists was performed. The survey closed on October 13, 2008. The survey achieved a 54% response rate. Eighty-two percent of respondents were male, mean age 42 (range, 34–68), median practice duration 6 years, with broad distribution of practices across the US. Seventy-five percent of respondents reported having general neurology residency plus additional fellowship training (54% vascular neurology fellowship, 13% neurocritical care, and 33% other no response). Fifty-one percent of neurohospitalists were hired by non-academic (private) institutions, whereas academic institutions hired 49%. There was a wide array of responses for call frequency, duration, number of practice partners, and annual income. A uniform definition of the neurohospitalist subspecialty emerged as one who cares for inpatients, focusing primarily on in-hospital responsibilities. Neurohospitalists defined themselves as inpatient neurological subspecialists. Neurohospitalists have a broad US geographic distribution (and possibly international), in both academic and private practice (or hybrid) forms, and typically provide inpatient and Emergency Department (ED) call coverage for hospitals or outpatient neurologic practices. Most neurohospitalists were involved in administrative aspects of stroke or inpatient quality initiatives.

Neurohospitalists represent a new approach to inpatient neurologic care. In order to characterize this practice, we surveyed both a general neurology sample as well as a sample of pertinent American Academy of Neurology sections. Of the section sample, 42% defined themselves as neurohospitalists, compared to 16% of the general sample. The majority of neurohospitalists are in an academic setting and share call responsibilities with non-neurohospitalists. Many are concerned about the possibility of burnout in their current practice setting. This representative sample of neurohospitalists reveals a diverse group facing a number of unanswered questions and challenges, including concerns for burnout, ideal practice setting, and defining the core curriculum for a neurohospitalist.

In this 2 part series, analysis of the risk stratification tools that are available, definition for the scope of the problem, and potential solutions through a review of the literature are presented. A systematic review was used to identify articles for risk stratification and interventions. Three risk stratification systems are discussed, St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, Morse Fall Scale, and the Hendrich Fall Risk Model. Of these scoring systems, the Hendrich Fall Risk Model is the easiest to use and score. Predominantly, multifactorial interventions are used to prevent patient falls. Education and rehabilitation are common themes in studies with statistically significant results. The second article presents a guide to implementing a quality improvement project around hospital falls. A 10-step approach to Plan-Do-Study-Act (PDSA) cycles is described. Specific examples of problems and analysis are easily applicable to any institution. Furthermore, the sustainability of interventions and targeting new areas for improvement is discussed. Although specific to falls in the hospitalized patient, the goal is to present a stepwise approach which is broadly applicable to other areas requiring quality improvement.