Risk and Safety Issues in Hospital-Based Medicine XVI examines patient safety risks related to the coordination of care aspect of the hospitalist’s role. This activity discusses risk points common to patients admitted for observation, the effects of using shared decision making to create a stable transition of care, and strategies that healthcare professionals can use to effectively document conversations with patients, families, and colleagues. The first case explores ways to respectfully engage with the care team and offers defensible documentation tips. The second and third cases focus on care transition planning, including strategies for incorporating shared decision making when developing discharge plans.