Many patient safety events in the health care industry are the result of the health care team not communicating important critical information about the patient's assessment and condition during hand-off communication from one caregiver to another. The purpose of this study was to examine the relationships between a structured fall prevention program to include the critical process of hand-off communication of patients fall assessment and strategies implemented, and outcomes of anticipated physiological fall rates. Both structured forms of verbal and written methods of hand-off communication (using a form similar to a goal sheet and face-to-face report) provided consistency in assessing patients individual fall risk factors, opportunity to implement interventions based on individual patient needs, and format to relate relevant information during hand-off communication with other staff. This study analyzed patient incident reports and review of medical records on patients who experienced a fall between fiscal year 2005 to 2007. The fiscal years were analyzed for evidence of effectiveness of both fall prevention and hand-off communication programs, utilizing a preintervention and postintervention methodology design. Information was aggregated and analyzed to establish importance of impact of hand-off communication on fall reduction in an inpatient setting, an acute medical and surgical unit.