Patient safety in health care remains a serious concern in Canada. Adverse events can lead to physiological and psychological complications and pose a significant economic burden on the health care system. The purpose of this descriptive qualitative study was to explore the team processes, roles and factors that underpin effective communication between team members during an OR-PACU handover. Content analysis revealed four major categories: Ownership, Distractions and Interruptions, Transfer of Information and Workflow. The results of this study, informed by the Theory of Collective Competence enhance our understanding of the OR-PACU handover and support the need for the development of a structured OR-PACU team handover process.