Improving the person-centredness of occupational therapy input into care planning in acute adult and older adults' inpatient services using Goal-Directed Care Plan guidelines.

Abstract

Background: Person-centred care planning is essential in mental health inpatient services, ensuring that patient goals align with clinical recovery plans. Despite its recognised importance, occupational therapists (OTs) in acute inpatient settings often face challenges in implementing structured, person-centred care plans within 10 days of admission based on the OT process within the acute inpatient services. The Goal-Directed Care Planning (GDCP) framework, previously successful in forensic and rehabilitation settings, was introduced to improve OT input into care plans in acute inpatient services.

Objective: This study aimed to enhance the person-centredness of occupational therapy care plans by implementing the GDCP framework, with a target of improving OT contributions from 27.44% to 70% by October 2024.

Methods: A quality improvement approach using multiple plan-do-study-act cycles was employed to embed the GDCP framework into three inpatient wards. Key interventions included standardising OT care-plan input, providing in-house training on care-plan audits, and ensuring timely documentation of patient goals and interventions. Monthly audits were conducted to assess progress and identify areas for further improvement.

Results: Across the board, OT input into care plans significantly improved from 27.44% (June-October 2023) to 53.25% (November 2023-October 2024). Ward-specific improvements were observed, with Ward T increasing from 24.42% to 43.32%, Ward M from 37% to 67.03% and Ward P from 21.09% to 44.34%. Key areas of improvement included clearer goal-action links and increased involvement of patients in care planning.

Conclusion: Implementing the GDCP framework enhanced the quality and consistency of OT contributions to care plans, fostering a more structured and outcome-driven approach. However, ongoing challenges such as workforce shortages and OTs being allocated to non-specialist roles in safer staffing need to be addressed to sustain improvements in person-centred care planning.