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MAMI- Quality Improvement at Marmara CF Center in Istanbul

In December 2022, MECFA wrapped up a 2 year quality improvement program aimed at increasing patient health outcomes in Turkey.

The MaMi program, a pilot and feasibility project established a care center able to manage all clinical aspects of patients with CF, following best evidence-based care guidelines and adapting them to Turkey’s setting. The program trained a multidisciplinary expert CF Team based in Turkey. The training occurred under direct and continuous

supervision of the University of Michigan (UM) CF Center, both in the US and Turkey. The program focused

on quality improvement (QI) projects with the UM CF team working closely with University of Marmara

(UoM) CF Center. Areas of QI work included improving BMI, improving pulmonary function testing,

implementing Infection Prevention and Control (IP&C) in the center. Once the pilot project was

consolidated, we used the programs approach at additional hospitals in Istanbul. This will be followed by

working with the 2 centers and MoH to develop 5-8 CF Centers, thus creating the National CF Center Network

in Turkey. This network will adhere and meet all the requirements of the Cystic Fibrosis Foundation for center

accreditation achieving after 5 or more years, a median life expectancy approaching 30 years of age. This will

be accomplished by cementing the National CF Center Network, using evidence-based, state of the art

healthcare delivery, operating under strict quality improvement principles, ongoing multidisciplinary team

training, and establishing a meaningful clinical research initiative.

This successful program helped patients increase their FEV1 and BMI over 20% in the first year, will be used as a template for similar educational program in Turkey and throughout the MECFA region.


The program was funded by educational grants from the CF Foundation and Vertex Pharmaceuticals.




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