Mediavilla Inmaculada, Anguita Manuel, González Franco Álvaro, Leal Manuel, Soto José Francisco
Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, 28046 Madrid, Spain.
UGC de Cardiología, Hospital Universitario Reina Sofía, IBIMIC, Universidad de Córdoba, 14004 Córdoba, Spain.
J Clin Med. 2025 May 12;14(10):3378. doi: 10.3390/jcm14103378.
Heart failure (HF) poses a significant global health burden. In Spain, its prevalence rises annually, contributing significantly to cardiovascular-related hospitalizations and deaths. Through a broad and integrative perspective, the CARABELA-HF initiative seeks to improve the organization and delivery of HF care in Spain, addressing the key challenges identified across the care continuum. CARABELA-HF involved four phases: characterization of HF care models, validation of improvement areas, potential solutions and healthcare quality indicators, refinement of results from a regional perspective, and local dissemination and implementation. Ten pilot centers participated, and nine variables were identified to characterize operating HF care models. Four HF care models were identified based on the degree of coordination between departments and resource availability. Structure, quality of care, and transformation indicators were used to evaluate these models, revealing improvement areas. Overall, this process identified solutions for generating a comprehensive and integrated HF care model, highlighting enhanced coordination, digital transformation, enhanced nursing roles, professional training and patients' education, accredited HF care models, resource accessibility, and data-based evaluation. CARABELA-HF provides insights into current HF care models in Spain and identifies healthcare quality indicators for future improvement efforts. It strives to enhance patient outcomes, raise healthcare standards, and improve overall system efficiency through the promotion of a comprehensive and integrated HF care pathway.
心力衰竭（HF）给全球健康带来了沉重负担。在西班牙，其患病率逐年上升，在心血管相关住院率和死亡率方面占很大比例。通过广泛而综合的视角，CARABELA-HF倡议旨在改善西班牙心力衰竭护理的组织和提供情况，应对在整个护理连续过程中发现的关键挑战。CARABELA-HF包括四个阶段：心力衰竭护理模式的特征描述、改进领域的验证、潜在解决方案和医疗质量指标、从区域角度对结果进行完善，以及在当地进行传播和实施。十个试点中心参与其中，确定了九个变量来描述现行心力衰竭护理模式的特征。根据部门之间的协调程度和资源可用性，确定了四种心力衰竭护理模式。使用结构、护理质量和转型指标对这些模式进行评估，揭示了改进领域。总体而言，这一过程确定了生成全面综合心力衰竭护理模式的解决方案，突出了加强协调、数字转型、强化护理角色、专业培训和患者教育、认可的心力衰竭护理模式、资源可及性以及基于数据的评估。CARABELA-HF深入了解了西班牙目前的心力衰竭护理模式，并确定了未来改进工作的医疗质量指标。它致力于通过推广全面综合的心力衰竭护理途径来改善患者预后、提高医疗标准并提升整体系统效率。
