de Miguel-Diez Javier, Diez Manglano Jesús, Mediavilla Inmaculada, Escudero Luciano
Pneumology Department of Hospital General Universitario Gregorio Marañón, Institute of Health Research Gregorio Marañón (IiSGM), Madrid, Spain.
Universidad Complutense de Madrid, Madrid, Spain.
Open Respir Arch. 2024 Nov 23;7(1):100387. doi: 10.1016/j.opresp.2024.100387. eCollection 2025 Jan-Mar.
Chronic obstructive pulmonary disease (COPD) is a serious global health problem that is ranked third among the leading causes of death worldwide. However, underdiagnosis remains common, especially in Spain. The CARABELA-COPD initiative aims to address these issues by optimizing processes across the diverse healthcare settings in Spain.
CARABELA-COPD employs lean methodology and fosters partnership between scientific societies, industry, clinicians, and managers to improve COPD care. The methodology consists of 4 phases: Phase 1 involved experts analyzing COPD care models and unmet needs; Phase 2, validation and priorization of improvement areas in 7 pilot hospitals, selecting healthcare quality indicators (QIs) in a national meeting; Phase 3, cocreation and refinement of results from a regional perspective; and Phase 4 is ongoing, disseminating the results and implementing them locally.
Initial phases of the initiative have defined a generic patient journey for COPD management from a multidisciplinary approach, identified 7 improvement areas for optimal COPD care, developed 4 care models tailored to different settings, and established QIs that have been validated in national and regional meetings.
CARABELA-COPD is a novel practical approach to COPD management in Spain that acts as catalyst for a system transformation to boost overall system efficiency and enhance patient outcomes. It provides a clear framework for improvement, emphasizing interdisciplinary collaboration and communication. The ongoing implementation phase will require flexibility and constant evaluation to further enhance COPD care, ultimately improving patient quality of life and healthcare effectiveness.
慢性阻塞性肺疾病（COPD）是一个严重的全球健康问题，在全球主要死因中排名第三。然而，诊断不足的情况仍然普遍，尤其是在西班牙。CARABELA-COPD倡议旨在通过优化西班牙不同医疗环境中的流程来解决这些问题。
CARABELA-COPD采用精益方法，并促进科学协会、行业、临床医生和管理人员之间的合作，以改善慢性阻塞性肺疾病的护理。该方法包括4个阶段：第1阶段，专家分析慢性阻塞性肺疾病护理模式和未满足的需求；第2阶段，在7家试点医院对改进领域进行验证和优先排序，在一次全国会议上选择医疗质量指标（QIs）；第3阶段，从区域角度共同创造和完善结果；第4阶段正在进行，传播结果并在当地实施。
该倡议的初始阶段从多学科方法定义了慢性阻塞性肺疾病管理的通用患者流程，确定了7个优化慢性阻塞性肺疾病护理的改进领域，开发了4种针对不同环境的护理模式，并建立了在国家和地区会议上得到验证的医疗质量指标。
CARABELA-COPD是西班牙一种新颖的慢性阻塞性肺疾病管理实用方法，它是推动系统转型以提高整体系统效率和改善患者结局的催化剂。它提供了一个明确的改进框架，强调跨学科合作与沟通。正在进行的实施阶段将需要灵活性和持续评估，以进一步加强慢性阻塞性肺疾病护理，最终改善患者生活质量和医疗效果。
