Handoffs and rapid response team (RRT) activations have been a focus for quality improvement in hospital medicine. This study aimed to incorporate a previously used scoring system (1-7) for severity of illness on initial encounter as a handoff adjunct and to determine its impact on the number of RRTs and intensive care unit transfers. The Patient Acuity Rating (PAR) scale correlates with subsequent RRTs and transfers to a higher level of care, with higher scores leading to increased rates of RRTs and transfers. Patients who experienced an RRT at any time (mean score 4.69), within 24 hours (4.74), or an unplanned transfer (5.16) had higher PAR scores on assessment than those who did not (4.02; all P < .05). There was an increased likelihood of RRTs and transfers with scores of 6 or higher. There was no reduction in the quantity of RRTs or unplanned intensive care unit transfers comparing preintervention and postintervention data.