Barriers, Enablers, and Impacts of Implementing National Comprehensive Care Standards in Acute Care Hospitals: An Interview Study

Background: Comprehensive care is increasingly being recognised as a critical component of healthcare, with several countries endorsing it as a national standard. This study aims to explore care professionals’ perspectives on the barriers, enablers, and impacts of implementing the Comprehensive Care Standard (CCS) in acute care hospitals across Australia. Methods: This is a qualitative descriptive study. Participants included 28 care professionals (20 nurses, 2 doctors, and 6 allied health professionals) recruited from a broad range of Australian acute care hospitals. Data were collected using semi-structured interviews from March to August 2023. The interviews were audio-recorded, transcribed and thematically analysed. Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR), and implementation strategies were mapped to the Expert Recommendations for Implementing Change (ERIC). Results: CFIR-informed analysis identified 12 barriers and 13 enablers to CCS implementation, most prominently within the Inner Setting and Implementation Process domains. Sixteen implementation strategies were also mapped using the CFIR-ERIC Mapping Tool. The perceived impacts of the CCS implementation were multifaceted. While CCS implementation brought about changes to hospitals and improvements in patient care, it also resulted in increased workload and fatigue among staff. Conclusions: Enhancing CCS implementation will involve addressing the barriers and building on the enablers identified in this study. Supporting more effective implementation may help maximise the benefits of the CCS for patient care while also mitigating the increased workload and fatigue reported by staff. These findings highlight the importance of approaches that balance quality improvements with staff wellbeing.