# Healthcare Models and Quality Indicators in the Management of Patients with Heart Failure in Spain: Results from the CARABELA-HF Initiative

## TL;DR

The CARABELA-HF initiative in Spain identifies heart failure care models and quality indicators to improve patient outcomes and healthcare efficiency.

## Contribution

The study introduces a structured approach to evaluate and enhance heart failure care models in Spain through regional and local implementation strategies.

## Key findings

- Four distinct heart failure care models were identified based on coordination and resource availability.
- Key improvement areas include digital transformation, nursing roles, and patient education.
- Healthcare quality indicators were developed to support integrated care pathways.

## Abstract

Background/Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.