Significant progress has been made in preventing errors at the time of handoffs between clinicians. As demonstrated in the landmark I-PASS study, patient safety can be improved by implementation of a standard format for verbal handoffs. This study—performed by the I-PASS study investigators—examined the quality of written signout documents, which are used by overnight covering physicians to complement the verbal signout. Written signouts were not standardized in either structure or content, and they frequently lacked information elements (such as illness severity) that are considered essential for a high-quality signout. Based on these findings, the authors make recommendations for the core data elements for written signouts. A case of a delayed diagnosis due to inadequate signout is discussed in a previous AHRQ WebM&M commentary.