BACKGROUND: With limited work hours, efficient rounding and effective hand-offs have become essential. We created a completely electronic medical record (EMR)-generated rounding report for use during pre-rounding, team rounds, and sign-out/hand-offs. We hypothesized that this would reduce workloads. METHODS: We used a pre- and post-implementation survey of the residents and faculty members of the Departments of Family and Community Medicine and Internal Medicine. RESULTS: After 5 months of use, residents and attending physicians reported a daily time savings of 44 minutes. Seventy-six percent of users also agreed that the rounding report improved patient safety. Rounding report users were more satisfied with the rounding process, spent less time updating other lists or documents, and less time pre-rounding. In addition, there were trends toward spending more time with patients, adherence to work-hour rules, increased accuracy of information during sign-out, improved satisfaction, confidence while cross-covering, and decreased clinically relevant errors. CONCLUSIONS: Utilization of well-designed, EMR-generated reports for the use of patient transfer, sign-out, and rounding should become more commonplace considering the improved efficiency, satisfaction, and potential for improved patient care