Hand-off at change of shift is a standard nursing process that occurs at least twice a day. It has the potential to cause gaps in communication and expose patients to adverse outcomes. Implementing a process that minimizes delay in assessing patients and setting priorities in care is beneficial in providing patients opportunities for positive outcomes. Bedside handoff at change of shift provides an interactive process of sharing with caregivers while including the patient and family. This process promotes patient-centered care and improves patient satisfaction. This process was piloted on our Stroke Unit and will be spread to all inpatient units in Fiscal Year 2011.