Clinical audit is a process that has been defined as a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit condition and the implementation of change. Historically, one of the first ever clinical audits was undertaken by Florence Nightingale during Crimean War in 1853. Clinical audits are normally carried out by a group of peers working in the same healthcare service or organization. Audit and its feedback are important reinforcement strategies that can help maintain clinician adherence to guidelines. Standard-based audit, significant event audit and peer review audit are three different types of audits in ICU. The process of transferring primary authority and responsibility for providing clinical care to a patient from one departing caregiver to one oncoming caregiver is called handoff. The handoff communication is the verbal and or written exchange of patient information occurring during transfer of responsibility and care giving activities. Strategy I (also called bed to bed, make sure all is said), strategy II (also called save the sick, do the others quick) and strategy III (also called new demand, change the plan) are three different strategy of handoff in ICU.