A third common care transition involving elders is the handoff of the hospitalized patient from one physician to another, such as for night or weekend coverage. Solet and coworkers reviewed the literature on such handoffs (few high-quality studies exist), and evaluated the handoff process at the four hospitals staffed by one Midwestern internal medicine residency program. Based on their work, they make four overall recommendations. First, handoffs of hospitalized patients should generally be made face to face, to allow the doctor assuming care of the patients to ask questions, to practice read-back skills, and to register nonverbal information such as facial expression, tone of voice, and body language. Second, the format for information transfer should be highly standardized. Third, the skill of handing off the care of complex and potentially unstable patients to another provider needs to be explicitly taught. And fourth, handoff skills need to be practiced repetitively, as is done by professionals in other high-risk occupations, such as air traffic handling. We believe these are reasonable recommendations, based on the information available to date, and we also endorse the authors' list of essential elements that should be passed on at the time of handoff. These elements include: patient identification, location, date of admission, a brief synopsis of the patient's admitting presentation, a list of currently active and pertinent past medical problems, medications and drug allergies, venous access (and how important it is that this be maintained), code status, key laboratory data, foreseeable problems with recommended contingency plans, and psychosocial concerns. Some or all of this information should be transmitted in written or electronic form (via computer or personal data assistant) as well as orally.