From Observation to Engagement Programme
From Observation to Engagement Programme
The Observation to Engagement Programme is supporting wards across the Trust to strengthen meaningful, therapeutic engagement with service users and safely reduce reliance on intermittent observations.
At the centre of the programme is the CARE that Counts bundle, which brings together practical change ideas that wards can adapt to their local context.
Programme progress
The programme began with Phase 1 pilot wards, where teams tested a range of change ideas to strengthen engagement and safely reduce reliance on observations. The ideas that showed the most impact were then brought together to create the CARE that Counts bundle. Across Phase 1, wards achieved a 49% reduction in enhanced observations, with no reported compromise to safety.
Phase 2 launched in March 2026, spreading the CARE that Counts bundle to a further 21 wards. Early data continues to build our degree of belief in the change bundle, with service user days on observations reducing by 43.4% from 1006.3 to 569.9 days.
Phase 3 launches in September 2026, completing the Trust-wide spread of the CARE that Counts bundle. Phase 3 wards will be supported to tailor the change concepts to their local context, while contributing to a more consistent Trust-wide approach to meaningful engagement and safer use of observations.
Important Key Resources
To support teams to test the CARE that Counts bundle in practice, we have developed two key documents. The two documents below are the main resources wards should use to move from ideas to action.
DIALOG+ training
DIALOG+ supports personalised care and support planning and is an important part of strengthening therapeutic engagement on the wards.
Staff are encouraged to book onto DIALOG+ training to build confidence in using DIALOG+ in practice. The training includes creative ways to engage service users, as well as the practical application of the DIALOG+ care planning process.
Questions?
For further support with the programme or CARE that Counts bundle, please contact your local Improvement Advisors.
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