Enhancing the Management of Severe Asthma in Spain: The CARABELA Initiative Disclosed.

Introduction: Severe asthma management is associated with increased healthcare resource use. The CARABELA initiative employs lean methodology to optimize severe asthma management in Spain. Material and methods: 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. Results: 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. Conclusions: 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.