16 January 2017

Organization chart

The Cystic Fibrosis Center of Tuscany Region (CFC) is recognized by the Region of Tuscany as a specialized regional center for cystic fibrosis (CF) as established by the national law n. 548 of 23/12/1993. The CFC is a Organized Autonomous Structure (SOSA) of the Interdisciplinary Specialized Department – Medicine Area of the Meyer Children’s Hospital (decrees N. 133 of 29/12/2015, N. 134 of 30/12/2015 and N. 140 of 30/12/2015).

The CFC has a Specialized Diagnostic Laboratory which carries out the following diagnostic activities: i) sweat test; ii) immunoreactive trypsin assay and meconium lactase for the neonatal screening program of CF; iii) standard microbiological and molecular biology tests for diagnosis and characterization of respiratory tract infections; iv) fecal elastase and steatocrit.

The CFC carries out the following healthcare activities:

  1. Out-patient or Day Hospital care for pediatric and adult patients, diagnosed with CF, or “Cystic Fibrosis Screen Positive Inconclusive Diagnosis” (CFSPID), identified through neonatal screening, and those with CFTR gene-related disorders.
  2. Consultant activities and organization of diagnostics for pediatric and adult patients with suspected CF or CFTR gene-related disorders.
  3. Ordinary, differentiated or age-related hospitalization of patients as follows: i) hospitalization for pediatric patients (up to age 18) is in the Specialized Interdisciplinary Department of the Meyer Children’s hospital; ii) hospitalization of adults is in the Infectious Diseases Ward of the Florence Careggi University Hospital. An agreement between the Meyer Children’s Hospital and Careggi University Hospital (decree n. 211 of 8/10/2008) established that some members of the multidisciplinary CFC team at the Meyer Children’s hospital, such as physiotherapists, dietitians, and psychologists, can also provide care to CF adults hospitalized in the Careggi Infectious Diseases ward. Instead, the nursing and medical personal for adult CF patients hospitalized in the Careggi Infectious Diseases ward, are personnel of the Careggi Hospital. The CFC Chief carries out a clinical supervisory role for adult CF patients at the Careggi Hospital.

The CFC coordinates a neonatal screening program for CF, which is part of the regional neonatal screening program and include hypothyroidism diagnosis and several other metabolic diseases.

The CFC also carries out scientific research on two primary topics: i) clinical and epidemiological microbiology, including multicenter projects; ii) international multicenter clinical research since the CFC is part of the Clinical Trial Network of the European Cystic Fibrosis Society (ECFS)(www.ecfs.eu/ctn).

The website of the CFC contains information on newborn screening program, symptoms and treatment of cystic fibrosis, organization of the CFC, outcome measures assessed in CF patients in follow up at the CFC, healthcare activities of the CFC, research projects of the CFC and patient-family education materials (www.fibrosicisticatoscana.org).

The Meyer Children’s Hospital and the CFC are included in the regional accreditation system and all of the checks performed have confirmed compliance with the accreditation requirements. The CFC has also obtained its own peer-based accreditation of excellence in March 2013. This Peer Review Accreditation Program is coordinated and sponsored by the Italian Cystic fibrosis Society and the Italian Patient-Family Organization (Lega Italiana Fibrosi Cistica). The first monitoring visit and assessment have been done by a multidisciplinary committee, which included also patient and family representatives, in March 2013: a total score of 3821 (66% of requirements with the best score of 3 – level 2) has been obtained.

The multidisciplinary team

The CF multidisciplinary team is comprised of CFC personnel, as well as members of the Meyer Children’s Hospital staff and that of the Careggi University Hospital. All of these team members utilize the demographic-clinical electronic database called “Camilla”, as well as the paper patient clinical chart. The team members participate in risk management and quality improvement initiatives and meetings, as well as in educational and updating endeavors organized by the respective coordinators and the CFC. The multidisciplinary team meets twice weekly, on Wednesday, which is dedicated to individual patient monitoring, and Friday, dedicated to organization problems and to the most relevant clinical difficulties which have arisen during the week.

Physicians

Cesare Braggion, M.D., specialist in Pediatrics, is a tenured, full-time physician of the CFC of the Meyer Children’s Hospital, and Chief of the CFC and its multidisciplinary team. He provides care for both children and adults with CF in both the in- and the out-patient clinics. He is Principal Investigator of the CFC and member of the Steering Committee of the Clinical Trial Network of the ECFS.

 

 

Giovanni Taccetti, M.D., specialist in Pediatrics, is a tenured, full-time physician of the CFC of the Meyer Children’s Hospital. He provides care for both children and adults with CF in the out-patient clinic and for children with CF in the in-patient clinic of the Meyer Children’s Hospital. He is Sub-Investigator of the CFC for multicenter projects of the Clinical Trial Network and project leader of clinical and epidemiological microbiology research.

 

 

Anna Silvia Neri, M.D., specialist in Pediatrics and Endocrinology, is a tenured, full-time physician of the CFC of the Meyer Children’s Hospital. She provides care for both children and adults with CF in the out-patient clinic and for children with CF in the in-patient clinic of the Meyer Children’s Hospital. She is responsible for clinical risk and quality management of the CFC.

 

 

Maria Chiara Cavicchi, M.D., specialist in Pediatrics, is a tenured, full-time physician of the CFC of the Meyer Children’s Hospital. She provides care for both children and adults with CF in the out-patient clinic and for children with CF in the in-patient clinic of the Meyer Children’s Hospital. She is responsible for organizing the CF neonatal screening program of the CFC.

 

 

Valeria Galici, M.D., specialist in Pediatrics, is a tenured, full-time physician of the CFC of the Meyer Children’s Hospital. She provides care for both children and adults with CF in the out-patient clinic and for children with CF in the in-patient clinic of the Meyer Children’s Hospital.

 

 

 

Vito Terlizzi, M.D., specialist in Pediatrics, is a full-time physician of the CFC of Meyer Children’s Hospital. He provides care for both children and adults with CF in the out-patient clinic and for children with CF in the in-patient clinic of the Meyer Children’s Hospital.

 

 

 

Silvia Bresci, M.D., specialist in Infectious Disease, is a tenured, full-time physician of the Careggi University Hospital. She is responsible for caring for CF adults hospitalized in the Infectious Diseases ward of the Careggi University Hospital and for those with severe pulmonary disease and those who have had lung transplant in the out-patient clinic of the CFC.

 

 

Beatrice Borchi, M.D., specialist in Infectious Diseases, is a tenured, full-time physician of the Careggi University Hospital. She is responsible for caring for CF adults hospitalized in the Infectious Diseases ward of the Careggi University Hospital, and for those with severe lung diseases and those who have undergone lung transplant in the out-patient clinic of the CFC.

 

 

Annalisa Cavallo, M.D., specialist in Infectious Diseases, is a tenured, full-time physician of the Careggi University Hospital. She is responsible for caring for cystic fibrosis adults hospitalized in the Infectious Diseases ward of the Careggi University Hospital and for patients with severe lung diseases and those who have undergone lung transplant in the out-patient clinic of the CFC.

 

[collapse]
Nurses

Ilda Fusco, R.N., is a tenured, full-time registered nurse at the CFC of the Meyer Children’s Hospital, working in the out-patient clinic of the CFC. She is responsible for organization of the specialized out-patient clinic and maintenance of structural components and equipment of the CFC.

 

 

 

Lara Biagi, R.N., is a tenured, full-time registered nurse at the CFC of the Meyer Children’s Hospital, working in the out-patient clinic of the CFC. She is responsible for CF nursing protocols and procedures for the CFC.

 

 

 

Antonella Ingicco, R.N., is a tenured, part-time (90.4%) registered nurse at the CFC of the Meyer Children’s Hospital, working in the out-patient clinic of the CFC. She is responsible for the pharmaceuticals and medical supplies as well as maintenance of medical equipment of the CFC.

 

 

[collapse]
Physiotherapists

Beatrice Ferrari, physiotherapist, is a tenured, full-time employee of the Professional Functional Rehabilitation Unit of the Meyer Children’s Hospital, specializing in lung diseases and intensive care. She works with CF patients in both the in- and out-patient clinics of the CFC.

 

 

 

Diletta Innocenti, physiotherapist, is a tenured, full-time employee of the Professional Functional Rehabilitation Unit of the Meyer Children’s Hospital, specializing in lung diseases and intensive care.  She works with both children and adults with cystic fibrosis in both the in- and out-patient clinics.

 

 

 

Matteo Masolini, physiotherapist, is a tenured, full-time employee of the Professional Functional Rehabilitation Unit of the Meyer Children’s Hospital, specializing in lung diseases and intensive care.  She works with both children and adults with cystic fibrosis in both the in- and out-patient clinics.

 

 

 

Chiara Castellani, physiotherapist, is a contract worker and employee of the Professional Functional Rehabilitation Unit of the Meyer Children’s Hospital, specializing in lung diseases and intensive care.  She works with both children and adults with cystic fibrosis in both the in- and out-patient clinics.

 

 

 

Eleonora Masi, physiotherapist, is a contract worker and employee of the Professional Functional Rehabilitation Unit of the Meyer Children’s Hospital, specializing in lung diseases and intensive care.  She works with both children and adults with cystic fibrosis in both the in- and out-patient clinics.

 

 

Riccardo Guarise, physiotherapist, is a contract worker and employee of the Professional Functional Rehabilitation Unit of the Meyer Children’s Hospital, specializing in lung diseases and intensive care.  She works with both children and adults with cystic fibrosis in both the in- and out-patient clinics.

 

 

[collapse]
Dietitians

Maria Luisa Guidotti, dietitian, is a tenured, full-time employee of the Professional Dietetic Clinic of the Meyer Children’s Hospital. She works with both CF children and adults in both the in- and out-patient clinics.

 

 

 

Elena Roselli, dietitian, is a contract worker and employee of the Professional Dietetic Clinic of the Meyer Children’s Hospital. She works with both CF children and adults in both the in- and out-patient clinics.

 

 

[collapse]
Psychologists

Caterina Teodori, psychologist, is a contract worker and employee of the Pediatric Hospital Psychology Service of the Meyer Children’s Hospital. She works with both CF children and adults in both the in- and out-patient clinics.

 

 

 

Paola Catastini, psychologist, is a contract worker and employee of the CFC of the Meyer Children’s Hospital. She works with both CF children and adults in both the in- and out-patient clinics

 

 

[collapse]
Social worker

Laura Mori, social worker, employee of the Social Worker Service of the Meyer Children’s Hospital. She works with both CF children and adults in both the in- and out-patient clinics. She collaborate with representatives of the Patient-Family Organization (Lega Italiana Fibrosi Cistica) in proposing benefits and allowances, according to Italian legislation, and in supporting home treatment.

[collapse]
Study coordination and data management

Michela Francalanci, biologist, is a contract worker and employee of the CFC of the Meyer Children’s Hospital. She coordinates the clinical studies and data management for both clinical research and the “Camilla” electronic database of the CFC.

 

[collapse]
The Specialized Laboratory of the CFC

The laboratory personnel are tenured, full-time employees of the CFC of the Meyer Children’s Hospital. This laboratory’s clinical microbiology activities, using standard culture methods and molecular biology methods for airway pathogens, have recently been made available to other operative units of the Meyer Children’s Hospital, as well as to other Regional Referral Centers for Cystic Fibrosis (CF) patients.

The diagnostic activities for CF neonatal screening (immunoreactive trypsin assay, meconium lactase and sweat chloride) also include genetic testing carried out in the Genetic Laboratory of the Careggi University Hospital. The CFC Specialized Laboratory carries out neonatal screening for CF for the Regions of Tuscany and Umbria and also for newborns of the San Giovanni Rotondo Hospital in Apulia.

The fecal sample analyses for digestive function (pancreatic fecal elastase 1 and steatocrit) are performed also for other hospitals in Tuscany.

The CFC Specialized Laboratory personnel also carry out clinical and epidemiological research, especially focused on applied microbiology for CF.

The CFC Specialized Laboratory employees are the following:

Silvia Campana, biologist, is a tenured, full-time employee of the CFC of the Meyer Children’s Hospital. Her duties include coordinating diagnostic activities and laboratory research. She is the person in charge of the laboratory budget for the CFC.

 

 

 

Novella Ravenni, biologist, is a tenured, full-time employee of the CFC of the Meyer Children’s Hospital. She is the person in charge of standard biochemical and microbiological methods, the new MALDI-TOF MS method and antibiotic susceptibility testing for the Laboratory.

 

 

 

Daniela Dolce, biologist, holds a fellowship for research projects. She is the person in charge of molecular biological methods applied to clinical microbiology and research.

 

 

 

Gianfranco Mergni, laboratory technician, is a tenured, full-time employee of the CFC of the Meyer Children’s Hospital. He is in charge of the stockroom, solid-waste disposal, and quality control programs of the diagnostic methods used.

 

 

[collapse]
Administration of the Regional Neonatal Screening Program

Administrative activity of the screening programs for cystic fibrosis, hypothyroidism and metabolic diseases involves acceptance and checking of samples taken at the birthing centers of the Regions of Tuscany and Umbria, as well as of specific diagnostic findings carried out by the Specialized Laboratories of the Meyer Children’s Hospital (CFC, Metabolic Diseases). Administration is carried out by using software for collecting demographic information as well as information from blood samples on blotting paper generated at the birthing centers, and diagnostic information from the Specialized Laboratories of the Meyer Children’s Hospital, which is then referred back to the birthing centers. Administrative personnel work 50% on CF screening and 50% on hypothyroidism and metabolic diseases screening. Administrative staff include the following:

Lucia Zavataro, administrator, is a tenured, full-time employee of the Meyer Children’s Hospital. She is in charge of management of the “Camilla” electronic database for the CFC.

Manuela Bonapace, administrator, is a tenured, part time (83%) employee of the Meyer Children’s Hospital.

 

 

 

 

Valentina Bacci, administrator, is a tenured, full-time employee of the Meyer Children’s Hospital.

 

 

 

[collapse]