This study observed 21 different handoff strategies in space shuttle mission control, nuclear power generation, railroad dispatching, and ambulance dispatching to draw conclusions about best practices and their application to health care settings. Using direct observations and interviews, investigators categorized specific handoff objectives and their associated strategies across issues such as improving effectiveness, efficiency, access to data, coordination with others, and the ability to enable error detection. The authors review common strategies that proved successful across the four settings and for the listed objectives. They also discuss the application of their findings to health care settings with suggestions for potential implementation.