Background & Problem: The Joint Commission and Accreditation Council for Graduate Medical Education all for standardized handoffs, citing communication failures as a top cause of sentinel events. Research shows the I-PASS handoff program reduced medical and preventable adverse events in residents at nine pediatric hospitals. Medication errors threaten patient safety and are linked to poor shift handovers, heavy workloads, and lack of a standardized report format at a suburban hospital. The hospital lacks an evidence-based handoff tool and reported medication errors rose by 84.6% from 2023 (n=13) to 2024 (n=24). Purpose: This Quality Improvement (QI) project aims to improve and standardize nurse communication during shift changes by implementing an evidence-based I-PASS handoff tool. The aim is to reduce medication, nursing, and imaging errors in these units to 0%. Methods: Key stakeholders were core nurses from two units, while float nurses were excluded. Core nurses completed I-PASS surveys after verbal handoffs on day and evening shifts. Prior to implementation, staff received I- PASS education via printouts, emails, and a mandatory session led by the project leader. Weekly chart audits were performed to track I-PASS compliance and error rates related to medication, nursing, and imaging orders. Results: Compliance with I-PASS was only at 10% (n=49) throughout implementation phase of 15 weeks. Highest compliance was in 2 weeks at 27% (n=129). The most common type of medication errors were medications that were not appropriately signed off as given or not. The most common type of nursing order errors was missed documentation of patient intake/output. The compliance goal of 80% was not met. Conclusion: Due to low compliance, no conclusions could be drawn on the handoff tool’s impact on medication, nursing, or imaging error rates. Making the I-PASS handoff tool a standard practice across the hospital and finding solutions to staffing issues will be important steps toward building on the progress made in this QI project