Handoffs at academic institutions in the United States have likely increased since the implementation of new duty hour regulations for residents in 2011, and several studies demonstrate that poor signouts are a risk factor for adverse events. While residency programs are required to provide formal training in signouts, the optimal format for written signout remains undefined. This controlled trial performed in a large internal medicine residency program demonstrated that implementation of a standardized, Web-based signout resulted in improved documentation of key information and improved resident perception of patient safety. The recent data and major issues around inpatient handoffs are summarized in this AHRQ WebM&M perspective.