Australian hospital professionals generally felt confident delivering comprehensive care—but the weakest point was creating one shared care plan, and nearly one in five reported that none of their unit’s patients had one. Comprehensive care is becoming a widely acknowledged standard for modern healthcare because it has the potential to improve health service delivery, affecting both patient-centred care and clinical outcomes.

In twenty nineteen, the Australian Commission on Safety and Quality in Health Care mandated implementation of the Comprehensive Care Standard. But little was known about its implementation and impacts in acute care hospitals.

The study therefore explored care professionals’ self-reported knowledge, experiences, and perceptions about the implementation and impacts of the Comprehensive Care Standard in Australian acute care hospitals. Acute care hospitals treat a majority of patients with acute, serious, or complex conditions, so care requires services from multiple professionals across disciplines and settings.

When care coordination is lacking, care can become fragmented, leading to unnecessary hospitalisation, longer hospital stays, and adverse events. That complexity helps explain the shift from disease-specific care toward a more comprehensive care approach.

The Australian Commission on Safety and Quality in Health Care defines comprehensive care as the coordinated delivery of the total health care required or requested by a patient. Its six essential elements are clinical assessment and diagnosis; identifying goals of care; risk screening and assessment; developing a single comprehensive care plan; delivering comprehensive care; and reviewing and improving its delivery.

Risk screening and assessment, together with minimising patient harm, is identified as a unique component of the Australian national standard for comprehensive care. Earlier work focused on implementation challenges but did not explore potential facilitators, and it targeted accreditation contacts rather than people working directly with patients.

There were also few studies examining the impacts of the Comprehensive Care Standard, leaving a gap around its challenges, facilitators, and effects. The study aimed to develop a national picture of care professionals’ self-reported knowledge, experiences, and perceptions in Australian acute care hospitals.

This study examined the care-professional perspective in acute care hospitals as part of a larger project involving care professionals, patients, and informal carers. It used a cross-sectional online survey administered through the Checkbox survey platform from October first, twenty twenty-two, to April thirtieth, twenty twenty-three.

Because no existing survey instruments were identified in the earlier literature review, the questionnaire was developed specifically for this study. The questionnaire was refined and pre-tested through a collaborative, iterative process to support content validity and an appropriate scope.

The target population was care professionals—doctors, nurses, and allied health professionals—working in Australian acute care hospitals who had heard about the Comprehensive Care Standard when surveyed. Quantitative data were analysed using R and RStudio, with descriptive statistics including means, standard deviations, medians, ranges, cross-tabulations, and proportions.

Because the variables were not normally distributed, the researchers primarily used the median as the more accurate measure of central tendency. The online survey received eight hundred sixty-four responses, and two hundred fifteen responses were excluded because they did not meet the study criteria described in the results section.

The sample included registered nurses or midwives, allied health professionals, and doctors, with forty percent being a manager, director, or leader in their profession. All Australian states and territories were represented, while forty-eight percent of respondents worked in regional areas and three-quarters worked in public hospitals.

Table one describes the survey sample across demographics, geography, workplaces, professions, leadership roles, and experience. Among respondents, two hundred sixteen were female, two hundred sixteen were from Queensland, two hundred one worked in regional locations, and three hundred sixteen worked in public organisations.

Registered nurses and midwives made up one hundred eighty respondents, while two hundred forty reported three to ten years of experience. The varying question totals matter because not every respondent completed every item. Respondents rated confidence in the six essential elements of comprehensive care on a five-point Likert scale, from very low to very high.

On average, respondents reported a high level of confidence in performing every element, with a median of four out of five. The lowest average perceived confidence was in developing a single comprehensive care plan, with a mean of three point five three and a standard deviation of one point zero seven.

Table two reports self-assessments on a zero-to-five scale, covering knowledge of the Comprehensive Care Standard, confidence in six comprehensive-care activities, and organisational support for implementation. Knowledge had a mean of three point three three, while confidence means ranged from three point five three for developing a single care plan to three point seven eight for identifying goals of care.

Organisational-support means ranged from three point three seven for education and training to three point five seven for leadership, with respondent numbers varying by item. Respondents reported moderate organisational support for education and training, systems and processes, and equipment and tools, with a median of three out of five.

Support was rated high for leadership, ongoing quality improvement, and standardisation of hospital practices and policy, with a median of four out of five. Education and training had the lowest average support rating among the six aspects, with a mean of three point three seven and a standard deviation of one point zero three.

Only four percent of respondents said all patients in their unit had a care plan meeting the Comprehensive Care Standard’s requirements. Twenty-nine percent reported that most patients had one, twenty-eight percent said half, and twenty-one percent said some patients had a Comprehensive Care plan.

At the other extreme, eighteen percent reported that none of the patients in their unit had a Comprehensive Care plan. Table four organizes exemplar quotes into seven themes explaining why care plans may not meet the comprehensive care standard. These include limited knowledge, staff motivation, nursing-dependent teamwork, resources, system processes, documentation burdens, and the clinical setting.

The quotations show practical barriers, such as a new plan described as an approximately thirty-six-page document, electronic-record limitations, and emergency or day-procedure environments where formal comprehensive plans may not be routinely written. Among respondents who were aware of the Comprehensive Care Standard, more than half perceived improvements in interdisciplinary collaboration, shared decision-making, and care continuity.

The same pattern included perceived improvements in patient quality of life, patient education, and patient satisfaction. Figure one shows respondents’ perceived effects after the Comprehensive Care Standard was introduced, with outcomes ordered by the share reporting improvement.

The clearest reported improvements concern interdisciplinary collaboration, shared decision-making, care continuity, patient quality of life, and patient education, while the chart also records “no change” and “worsened” responses across outcomes such as readmissions, adverse events, psychological distress, and health-care costs.

This matters because it captures professionals’ perceptions of the standard’s broad effects, including both potential benefits and concerns. The study’s conclusions are limited by selection bias because only professionals who had heard about the Comprehensive Care Standard were included, and people more interested in or knowledgeable about it may have been more likely to participate.

Recall bias is also possible because there was no baseline survey before implementation and the survey took place five years after the Standard’s release. Missing data later in the survey may indicate respondent fatigue or drop-out, possibly related to survey length or limited understanding of implementation.

The survey suggests that the Comprehensive Care Standard is associated with perceived improvements in several aspects of care, but implementation remains uneven: confidence is not the same as organisational support or consistent care-plan use.