The physician on the left—who clearly has been on duty or on call all night—is attempting to convey information about his patients to the incoming providers. However, the incoming physician appears unengaged and is unhappily scanning the notes in her hand and has a wireless earbud in her ear. The nurse on the right is concentrating on drinking his coffee and seems to be paying no attention to the hand-off at all. Moreover, the team members’ focus is not enhanced by the fact that they are choosing to conduct a hand-off in a chaotic, noisy environment.