Crespo-Lessmann Astrid
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Open Respir Arch. 2024 Nov 14;7(1):100378. doi: 10.1016/j.opresp.2024.100378. eCollection 2025 Jan-Mar.
Severe asthma management is associated with increased healthcare resource use. The CARABELA initiative employs lean methodology to optimize severe asthma management in Spain.
Scientific Societies, clinicians, healthcare management and industry stakeholders implemented lean methodology to reorganize and optimize processes and design a practical, individualized approach to improve quality of care for the management of severe asthma patients. This initiative involved four phases: Phase 1 characterized severe asthma management models in six pilot hospitals, identifying improvement areas; Phase 2 validated and prioritized these areas and healthcare quality indicators in a National Workshop; Phase 3 focused on regional meetings to co-create and refine solutions; and Phase 4 is disseminating and implementing results locally by applying a digital tool and organizing tailored workshops.
This CARABELA initiative identified 87 improvement areas, mainly in diagnosis and care coordination, and developed solutions emphasizing awareness, nursing roles, patient education, and communication. National and regional meetings produced 112 cocreated solutions and established healthcare quality indicators. Thirty-six hospitals are now implementing tailored improvement plans.
The CARABELA-SA initiative revealed variability in severe asthma management across Spain, underscoring the need for standardized healthcare quality indicators. By engaging nearly 200 professionals, the initiative fostered collaboration and innovation and established a framework for ongoing improvement in managing severe asthma and other chronic diseases. The CARABELA initiative promotes patient-centered care and interdisciplinary collaboration with the objective of enhancing patient outcomes and healthcare efficiency.
重度哮喘管理与医疗资源使用增加相关。CARABELA倡议采用精益方法优化西班牙的重度哮喘管理。
科学学会、临床医生、医疗管理部门和行业利益相关者采用精益方法重组和优化流程,并设计一种实用的个性化方法,以提高重度哮喘患者管理的护理质量。该倡议包括四个阶段:第一阶段对六家试点医院的重度哮喘管理模式进行了特征分析,确定了改进领域;第二阶段在全国研讨会上对这些领域和医疗质量指标进行了验证和排序;第三阶段侧重于区域会议,共同创建和完善解决方案;第四阶段通过应用数字工具和组织定制研讨会在当地传播和实施结果。
CARABELA倡议确定了87个改进领域,主要在诊断和护理协调方面,并制定了强调意识、护理角色、患者教育和沟通的解决方案。全国和区域会议产生了112个共同创建的解决方案,并建立了医疗质量指标。目前有36家医院正在实施定制的改进计划。
CARABELA-SA倡议揭示了西班牙重度哮喘管理的差异,强调了标准化医疗质量指标的必要性。通过让近200名专业人员参与,该倡议促进了合作与创新,并建立了一个持续改进重度哮喘和其他慢性病管理的框架。CARABELA倡议促进以患者为中心的护理和跨学科合作,目标是提高患者结局和医疗效率。