REGARDLESS OF THE INDUSTRY, risks are inherent in any work process that relies on the transfer of critical information from one person to another. In aviation, from which much of healthcare's work in safety and error reporting has been extrapolated, transfers of information are marked by the use of standardized communication patterns and devices, such as checklists, to reduce the risk of miscommunication, misunderstanding, and the omission of critical information. By the time an aircraft is cleared for takeoff on the runway, numerous communications have taken place between and among the cockpit crew, the control tower, the ground staff, the cabin crew, and others. Dynamics outside of everyone's control, such as weather, are accounted for and factored into the calculations to ensure a safe flight. Additionally, multiple redundancies are built into these exchanges of information to ensure accuracy and comprehension. Aviation has indeed maximized the use of technology, and has augmented its successful implementation by standardizing human processes and placing a premium on strong teamwork among the crew. This tripartite approach to communicating critical information is one reason aviation is among the safest of industries. A patient's journey through the healthcare system is punctuated by many similar exchanges of critical information, or handoffs, when either the patient is moved from one care setting to another or when the patient's care providers change. In 2006, the Joint Commission determined that handoffs should be a National Patient Safety Goal (NPSG), under the rubric of improving] the effectiveness of communication among caregivers.1 NPSG 2 states that the primary objective of a handoff is to provide accurate information about a [patient]'s care, treatment, and services; current condition; and any recent or anticipated changes. It further identified five elements that should be included in each handoff: 1. Interactive communication that allows for the opportunity for questioning between the giver and receiver of patient information 2. Up-to-date information regarding the patient's condition, care, treatment, medications, services, and any recent or anticipated changes 3. A method to verify the received information, including repeat-back or readback techniques 4. An opportunity for the receiver of the handoff information to review relevant patient historical data, which may include previous care, treatment, and services 5. Interruptions during handoffs are limited to minimize the possibility that information fails to be conveyed or is forgotten Handoffs encompass a broad range of information-sharing opportunities, from a simple report on a stable patient between an off-going and an oncoming nurse, to an ambulance crew bringing a critically injured patient into the emergency department (ED). Transitions in care are an inevitable part of healthcare delivery, whether the patient is moving geographically from one setting to another-emergency department to inpatient unit; intensive care unit (ICU) to operating room; unit to procedural area; or hospital to home at discharge-or when the patient remains in the same care area but the caregivers go off shift and new physicians, nurses, and other providers come on. During any hospitalization, a patient may also be cared for by a variety of other practitioners who all add information to the patient's treatment plan. In this article, we share methods that our institution, the Johns Hopkins Hospital, uses to improve the handoff process in the inpatient setting. In the feature articles, Chugh and colleagues and Bisognano and Boutwell discuss the challenges unique to handoffs from the hospital to home. As Bisognano explains, improving this transition can reduce the likelihood of readmission, an important marker of efficiency and quality. Chugh describes the role that health literacy and cognitive impairment play in a patient's ability to comprehend and adhere to discharge instructions, thereby reducing the probability of being re-hospitalized. …