The healthcare system needs to evolve. The AVANCE Project led by the Alianza de la Sanidad Privada Española (ASPE) is the private sector’s response to drive change and make it possible.
The AVANCE Project is the first sector-wide framework designed to develop the skills of the nursing team within the Spanish private healthcare sector. It represents the private sector’s response to the evolving needs of the healthcare system, with the primary goals of identifying areas for professional development and establishing a standardized model for widespread implementation.
The project is led by the ASPE Nursing Committee, a technical body composed of nursing directors representing more than 150 hospitals. This committee is responsible for identifying focus areas, validating the model, ensuring scientific rigor, and overseeing implementation. To ensure that skills development is measurable, consistent, and verifiable, the project relies on a structured governance system. This framework includes accrediting training programs for three-year periods (subject to periodic renewal) and providing professional certification to students who successfully complete the accredited training. The project is systematically organized into separate workstreams, each addressing a specific area of care, and is implemented and validated progressively.
The initial operational implementation of the project, Workstream I (Model for delegating tasks to TCAE in the operating theatre), has been successfully completed. This outcome was built on real-world evidence gathered from 21 interviews with operating theatre supervisors and is supported by a legal framework (LOPS Law 44/2003). It successfully defined a matrix of delegable activities, nursing supervision structures, TCAE role requirements, and a dedicated training program. Furthermore, the project continuously measures its outcomes through an annual implementation report, which tracks the number of certified professionals, accredited training programs, and key performance indicators like safety and efficiency of care, and job satisfaction. ASPE accredits training programs and certifies students.
The AVANCE project operates on a system of continuous evaluation and improvement, with several new workstreams currently underway or planned. Line II (Advanced Nursing Triage) and Line III (TCAE in Outpatient Clinics) are currently in progress. Future phases of the project will focus on Line IV (Nursing in clinics, prioritizing Oncology and Cardiology) and Line V (TCAE in the ICU). To ensure long-term success, the project will conduct regular quality assessments to evaluate its impact, identify areas for improvement, and implement necessary updates, driven by the core philosophy that “efficiency is not an option; it is a responsibility towards patients and the healthcare system.”
