Problem and Purpose Poor communication between incoming and outgoing nurses during shift change handoff contributes to adverse safety events, communication errors among healthcare personnel, and decreased patient satisfaction. Shift Change Handoff (SCHO) was implemented in 2017 throughout a hospital system, with compliance measured monthly using the Press Ganey Scale. Prior to 2020, a medical-surgical unit consistently achieved >75% compliance. Since 2020, compliance declined to 29%- 60%. From July 2023 to February 2024, 29-60% of patients responded “always” to “Shift Change Handoff communication was done”. Thirty-three percent-62% responded “always” to being included in SCHO. A root cause analysis identified nurse turnover, patient isolation, limited education, and the prior nurse’s absence as key factors affecting compliance. This quality improvement project aims to enhance bedside SCHO compliance on a medical-surgical unit by implementing the Introduction, Situation, Background, Assessment, Results, Questions (ISBARQ) standardized handoff tool—an evidence-based approach—and measuring nursing adherence to bedside SCHO. Methods: A standardized ISBARQ- based handoff tool was used. An interdisciplinary team, including RNs, LPNs, and nursing leadership, supported implementation. Education was delivered during shift change huddles to ensure all 40 RNs and LPNs were trained on the handoff tool, bedside SCHO, previous compliance data, and the compliance goal. Weekly patient audits were conducted, and data from the audits and Press Ganey Scores were reviewed. Nurses received additional one-on-one education when patients did not respond “yes” on audits. Results: Data from 108 patients showed a 97% bedside SCHO completion rate, and 90% of patients reported being included in SCHO. Patients with altered mental status or on agitation medications were excluded. Conclusion: Implementing a standardized handoff tool improved bedside SCHO compliance and enhanced communication between nurses and patients.