Post-surgical handoffs of patients requiring intensive care threaten patient safety. Within the hospital, these patients are transferred from one site and team of care to another, and they are often incapacitated and thus unable to participate in their care. Loss of critical information occurring in the transition process predisposes to error and preventable harm. The Handoffs and Transitions in Critical Care (HATRICC) project is employing qualitative and quantitative methods to improve and measure the postoperative handoff process in two Penn surgical intensive care units. This project (HATRICC-US) is a multicenter offshoot of work started at Penn in 2014. In our prior work, we created and implemented a standardized operating room to intensive care unit handoff process that decreased communication failures and improved patient outcomes. We now seek to spread and scale that work to other U.S. academic medical centers because uptake of handoff protocols is inconsistent across the nation.