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This article outlines the implementation and deployment strategy defined by the Catalan healthcare system which sought to promote a plan to strengthen and transform primary care in order to provide high-quality healthcare services whilst making an optimal use of resources across the Catalan region.
Background:
Following the COVID-19 pandemic, the Catalan healthcare system initiated a plan to enhance primary care services. The Lean methodology has been used extensively in other sectors for process improvement. More recently, it has been adopted in large hospitals, showing good results, so Lean was selected as the most appropriate method to achieve this project’s goal. The Process Office of the Catalan Health System, which is made up of experts in Lean methodology, has been involved in defining and deploying the strategy to all 374 Primary Care Teams (PCTs) within the Catalan healthcare system.
Methods:
The deployment strategy was executed in four phases (each consisting of a number of sessions): (1) explaining the project’s goals and training the professionals in the methodology; (2) assessing the current status regarding the processes with the various PCTs; (3) identifying and implementing improvement projects; and (4) defining key performance indicators to monitor the impact of the projects.
Findings:
As a conclusion, this project has allowed to successfully define and implement a standard at a strategic and deployment level of a project for primary care improvement that may be replicated in other regions. The key elements to ensure success have been the following: leadership, implementation of an improvement methodology, standardization of sessions, and involvement and training of front-line professionals.
Edited by
Dan Chamberlain, University of Turin,Aleksi Lehikoinen, Finnish Museum of Natural History, University of Helsinki,Kathy Martin, University of British Columbia, Vancouver
This chapter summaries what is known about population trends of mountain birds, especially in Europe and North America. A European mountain bird indicator, which summaries the population trends of 44 alpine species, suggests an overall slightly increasing mountain bird population during 2002–2020. Regional North American indicators, based on up to seven alpine species showed either stable or declining trends during 1968–2020. In European mountains, cold-dwelling species had on average less favourable regional population trends than warm-dwelling species, and long-distance migrants tended to have more negative trends than short-distance migrants and residents. There were also spatial differences in trends of the indicators in Europe: mountain birds in general increased in the Alps but decreased in the UK. A comparison between two European breeding bird atlases showed that the distribution area of mountain birds has generally decreased since the 1980s, and mountain specialists have lost more of their range than mountain generalists. Monitoring alpine species presents many challenges which has led to poor coverage in surveys even in areas with well organised bird monitoring programmes at low elevation. The necessary future improvements needed for successful bird population monitoring in mountain areas will, in many instances, require strong financial support.
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