- AI Software Development Services
- Mobile App Development
Nurse shift handoff is one of the most critical moments in hospital care. It is the point where one nurse transfers responsibility for a patient to another, often at the end of a demanding shift and in an environment full of interruptions. For years, this process has relied on individual memory, personal routines, and whatever notes a nurse had time to prepare.
Levi Knudson, founder of ShiftGuard, spent 15 years as a registered nurse, with much of that experience in the ER. During that time, he saw the same handoff risks appear again and again. The issue was not a lack of skill, attention, or commitment from nurses. It was a workflow gap: critical patient information had to be organized and communicated under pressure, without a dedicated tool built for that moment.
Levi brought the concept to Intersog. Together, we transformed his frontline clinical insight into ShiftGuard: a lightweight, HIPAA-aware mobile handoff assistant designed to help nurses create structured, consistent, and reliable patient reports without adding unnecessary complexity, documentation burden, or integration barriers that could slow hospital adoption.
The Challenge
On paper, nurse shift handoff should be a simple process. In a real hospital setting, it is one of the most interruption-heavy parts of the day. Call lights are active, new patients are being admitted, family members need answers, and the outgoing nurse is often finishing tasks while trying to communicate the patient story to the next nurse coming on shift.
The EMR contains extensive patient information, but it was not built to function as a real-time handoff tool. Turning a full patient chart into a concise, prioritized verbal report still depends on the nurse’s ability to quickly identify what matters, organize it clearly, and communicate it accurately under pressure.
That gap between clinical documentation and practical communication is where important details can be missed.
“We keep expecting nurses to carry all of this in their head during one of the busiest moments of the shift. That felt broken to me. I wanted to build something that supported the nurse in real time instead of adding another burden.”
Levi Knudson, Founder, ShiftGuard
- The product vision was clear, but the MVP required careful product and technical decisions:
- Designing a nurse handoff workflow that could function without long-term patient data storage, while keeping the product lightweight enough for pilot use and practical enough for real clinical environments.
- Creating an interface fast and simple enough to fit into nursing workflow, where every extra click can become a barrier to adoption.
- Balancing clinical accuracy with usability, so a non-technical founder could test the product, provide feedback, and iterate quickly throughout development.
- Keeping the MVP tightly focused and avoiding unnecessary feature expansion, while preserving a clear single-purpose experience around the shift handoff moment.
Solution
ShiftGuard is a structured nurse handoff app designed around the way nurses already organize and communicate patient information. It does not aim to replace the EMR or introduce another documentation layer. Instead, it supports one specific, safety-critical workflow: the verbal patient handoff during shift change.
With ShiftGuard, a nurse can open the app, set up their patients, and structure the patient story around key clinical categories, including current status, risks, pending tasks, medications, plan of care, and follow-up needs.
As a result, the receiving nurse gets a clearer and more consistent report. The handoff becomes more reliable, and nurses spend less time chasing missing context or clarification.
Several product and UX decisions defined how ShiftGuard was built:
No long-term patient data storage
ShiftGuard supports the handoff workflow without turning into a medical record. This decision was intentional from the start. It helps reduce HIPAA-related risk, eliminates the need for EHR integration during pilot use, and allows hospitals to evaluate the product without a lengthy compliance or implementation process.
SBAR-aligned structure
The app follows a communication model nurses already know and use. By aligning the workflow with established clinical handoff practices, ShiftGuard keeps the learning curve short and makes the product easier to introduce in real care settings. Most nurses can understand the core workflow after a single training session.
Lightweight onboarding
ShiftGuard is designed for fast pilot deployment with minimal implementation effort. Hospitals can test the product without a major technical build, system integration, or extended rollout timeline.
Focused scope
The MVP remains centered on one use case: the nurse handoff moment. Features that could add complexity, expand the product footprint, or distract from the core workflow were intentionally moved out of the initial scope.
The collaboration remained highly iterative throughout the project. Levi contributed the clinical perspective and practical feedback of a working nurse, while the Intersog team translated that insight into a usable mobile app experience. Together, we reviewed features, tested workflows, identified friction points, and refined the product until it reflected how nurses actually move through a shift.
Today, ShiftGuard is best suited for inpatient units with structured, repeatable handoff workflows, including med-surg, telemetry, ICU step-down, observation, behavioral health, and rehabilitation. These are the clinical environments where communication gaps can have the greatest impact, and where a consistent handoff structure can make a meaningful difference.
Results
ShiftGuard has reached the MVP and early demonstration stage: a working healthcare product that can be shown, tested, and evaluated in a real clinical environment. For an early-stage nurse handoff app built by a solo founder with deep clinical experience rather than a software background, this is the milestone that matters most.
Early conversations with nurses and hospital leaders have been positive. The problem is immediately recognizable to people who understand the risks around shift handoff and patient communication. The feedback has been consistent: the tool must remain fast, simple, and genuinely useful within real nursing workflow — and ShiftGuard was built around that requirement.
The planned pilot metrics are aligned with how healthcare teams evaluate early-stage adoption: nurse usability, perceived handoff completeness, confidence in receiving report, missed follow-up items, time spent preparing and clarifying report, and overall workflow fit. The goal is to validate whether a structured handoff assistant can reduce communication gaps, improve nurse efficiency, and support better patient-safety outcomes before the product expands further.
"A successful deployment means nurses actually use the tool because it makes handoff easier and more reliable. For a hospital, winning would look like more consistent reports, fewer missed handoff elements, less time spent chasing clarification after shift change, and greater nurse confidence during transitions of care.”
Levi Knudson, Founder, ShiftGuard
What’s Next
The immediate priority is to bring ShiftGuard to hospital quality and nursing leaders and move the product into structured pilot programs. The first unit to pilot the app will help validate it against real clinical workflow and generate the measurable data healthcare teams need to support adoption decisions.
Looking ahead, the same handoff-reliability model could be applied to other high-risk communication points across the hospital, including ER-to-floor handoffs, transfer reports, discharge readiness communication, break coverage, and charge nurse updates. The foundation built for ShiftGuard is designed to evolve with the broader clinical communication challenge.
Hospitals interested in ShiftGuard can explore a demo and discuss pilot opportunities at shiftguard.info.
