CARABELA-COPD: A Novel Approach for the Transformation and Improvement of the Healthcare Process in COPD Management in Spain.

Introduction: 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. Material and methods: 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. Results: 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. Discussion: 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.