Posted on: 3 October 2025
A clinical team at the Brent Older Adults Community Mental Health Team (CMHT), led by Dr Charlotte Dinkel, Dr Anand Ramakrishnan, and Dr Lakmini Ranasinghe, identified challenges with DIALOG+ care plans for older adults. Staff spent excessive time completing them, often missed deadlines, and produced inconsistent documentation, posing risks to care quality, equity, and safety.
To address these issues, the team undertook a quality improvement (QI) project to reduce the average time taken to complete care plans by 20% over six months, improve the quality of documentation, and enhance staff-patient interactions.
A structured, streamlined DIALOG+ care plan template was co-produced with staff and Experts by Experience for testing, and the results were impressive. Time to complete care plans decreased by an average of 59%, with some staff reporting reductions of up to 80%. Staff surveys showed unanimous agreement that the template improved both the efficiency and quality of care plans. Additionally, 75% of staff felt it facilitated better discussions with patients and carers.
Patient feedback was equally positive. All surveyed patients felt their care plans reflected agreed outcomes and appreciated the clarity and involvement the new format provided. An audit revealed a shift from vague and impersonal plans to comprehensive and personalised documentation in 73% of cases.
The project has gained significant traction across the Trust and beyond. It was presented at the Royal College of Psychiatrists QI Conference, an Improvement Academy board meeting, learning events in Brent and won a prize at CNWL’s Resident Doctor QI Presentation event, receiving endorsement from clinical leads for wider implementation.
A year on, all staff are continuing to use the template, with 90% confirming its impact on time efficiency and care quality.