Every day the care of hospital patients is handed off from clinician to clinician, creating serious risks for patient safety. The Joint Commission and the Accreditation Council for Graduate Medical Education have called for institutions to implement standardized handoff strategies. However, despite mandates to create safer handoffs, this systematic review found a lack of reliable strategies to improve clinical handoff outcomes. The literature search uncovered 29 relevant handoff studies, only 2 of which were randomized controlled trials. The studies took varied approaches to intervention design and outcome measurement. The quality of most studies was poor, with the majority representing small, uncontrolled, unblinded before-and-after comparisons. The authors of this review call for establishing a common taxonomy to better classify handoffs, improvement methods, and outcomes. Dr. Vineet Arora discussed the challenges of handoffs in a prior AHRQ WebM&M interview.