Deficiencies
The collaboration started with a site visit in 2018. The following deficiencies were identified:
  1. A high number of patients had low BMI Z scores: Median Z score was -1.2 (25th and 75th: -2.2- -0.2), -0.2 (25th and 75th: -1.5-0.4), and -0.6 (25th and 75th: -1.3-0.1) in patients 2-5, 6-11, 12-17 years old, respectively. The BMI Z score was lower in all age groups compared to the peers registered in ECFSPR.
  2. A high number of patients had FEV1 pp values which trended down as they got older: Median FEV1 pp was 86.1 (25th and 75th%:70.5-97.8) in 6-17 years compared to 60.8 (25th and 75th: 40.5-73.3) in patients 18-24 years old.
  3. Inadequate structural integration of Ma CFC with Physiotherapy and Physical Medicine and Rehabilitation department (PM&R). Patients were receiving consultation for airway clearance, bronchial hygiene techniques and exercise programs as needed especially while hospitalized.
  4. The center had no infection prevention and control (IP&C) policies or measures in place.
  5. Although there was an outpatient clinic schedule in place, patients with mild to moderate CF exacerbation were seen in the CF clinic without a scheduled appointment.
  6. Clinic space was inadequate and not suitable for CF patients follow up.
  7. Inadequate Allied Health professionals support to the center, including CF nurse, dietetian, physical therapist. Ma CFC had no social workers or psychologists in the institution..