Effective communication and coordination among care teams is essential to the delivery of high quality, safe health care. This article introduces the Multi-Team Shared Expectations Tool (MT-SET), which is used to improvement team communication, engage teams in eliciting needs and establishing shared expectations among teams and individuals. A pilot evaluation of the MT-SET in perioperative and inpatient care units at Johns Hopkins University School of Medicine found that the MT-SET tool fostered better cross-unit teamwork and coordination, but issues such as care delays and inconsistent communication persist.