I work in a 25-bed MICU at a university hospital system, and I think our RN to RN report system is very effective, and thorough, which is a problem I think on many floors. Basically the report on each patient goes as follows: basic data (age, race, code status, allergies), then past medical history, then a summary of events leading up to the patient's current status (i.e. date of admission to hospital, major procedures/complications this hospitalization, then the current plan), then a head-to-toe summary of the patient's current condition. Usually when I report, I start with the neurological status, then respiratory, cardiac, GI/GU, skin, etc. I finish report by showing lab results/ABG results and discussing family issues. After the verbal report, I check all the new doctor's orders for the past shift with the new nurse, and we do a double-check of all drips together. I know this sounds extremely detailed and tedious, but it is an excellent system and is used consistently by all nurses on our unit. It really helps me get a thorough picture of my patient(s) before starting the shift, and it's great because if something unexpected comes up and I don't get the chance to sit down and read the charts that shift, I already know enough to accurately discuss the patient with the medical team. I hope this helps. :)
As far as the Kardex question goes, our charting system is almost 100% computerized. We chart all assessments, labs, vitals, etc. on computer and we actually have a computerized Kardex page that the nurses update throughout the shift as needed. It is really handy and very accessible from any computer on the unit. I love it!