Care plans are required by the Joint Commission on Accreditation of Healthcare Organizations. Each day nurses create and file these plans in medical records. However, current forms of care plans do little to either enhance the flow of information or communicate shared patient goals. This paper introduces the theoretical model underpinning the HANDS care planning method and presents findings on the first year of a 3-year multisite study in which this method and a new Health Information Technology (HIT) application supporting the process were introduced. The theoretical model is derived from research on high reliability organizations and encompasses collective mind, mindfulness, and heedful interrelating. It focuses on the handoff as a focal point for not only information transfer but also reinforcing shared meaning and goals. The specific application, HANDS, integrates the NANDA, NIC, and NOC terminologies as a means of ensuring shared meaning across shifts and units. Early findings show the method has the potential of revolutionizing nursing practice.