SERVICE CHART
HADRONTHERAPY:
MORE PRECISE ON THE TUMOUR,
LESS INVASIVE ON THE PATIENT.
A new energy against tumours
1 SUMMARY NATIONAL CENTER OF ONCOLOGICAL HADROTHERAPY .................................................. 4 THE QUALITY POLICY ‐ THE MISSION AND THE VALUES OF CNAO ................................... 4 HADRONTHERAPY ............................................................................................................ 6 CLINICAL ACTIVITY ............................................................................................................ 6 The Outpatients' Clinic ........................................................................................................................... 7 The diagnostic imaging and nuclear medicine service .......................................................................... 8 The hadrontherapy service area ............................................................................................................ 8 The therapeutic clinical path .................................................................................................................. 9  Preliminary clinical path – programming treatment plan ............................................................... 9  Treatment Plan Elaboration ............................................................................................................ 9  Treatment Cycle using Hadrontherapy ......................................................................................... 10  Treatment End ............................................................................................................................... 10  Patient Follow up ........................................................................................................................... 10 Recognizing CNAO health‐care staff .................................................................................................... 10 RESEARCH AT CNAO ....................................................................................................... 11 Clinical Research ................................................................................................................................... 11 High‐ Technology Research .................................................................................................................. 11 PATIENT RIGHTS ............................................................................................................. 13 Information .......................................................................................................................................... 13  Informed Consent .......................................................................................................................... 13  Exam Preparation and post examination information .................................................................. 13  Clinical report ................................................................................................................................ 14  Medical Records Copy Request ..................................................................................................... 14  Healthcare Staff Identity ............................................................................................................... 14  Non‐executable Service ................................................................................................................. 14  The right to obtain explanations ................................................................................................... 14  Foreign Patient .............................................................................................................................. 14 Conventions ......................................................................................................................................... 14 Privacy .................................................................................................................................................. 14 Protection ............................................................................................................................................. 15  Patients Protection ........................................................................................................................ 15  Public relations .............................................................................................................................. 15  Complaints about the service ........................................................................................................ 15  The patient's goods ....................................................................................................................... 15 Safety .................................................................................................................................................... 15  Medical Assistance ........................................................................................................................ 15  In the event of an emergency (fire, flood etc.) ............................................................................. 16  Surveillance Service ....................................................................................................................... 16 Recognition of physical/architectural barriers and protection ........................................................... 16 Smoke ................................................................................................................................................... 16 RIGHT TO SUBMIT SUGGESTIONS OR COMPLAINT ........................................................ 16 Questionnaires ..................................................................................................................................... 16 CNAO SEATS ................................................................................................................... 17 OVERNIGHT STAY ........................................................................................................... 18 FOOD SERVICE ................................................................................................................ 20 SUPPORT US ................................................................................................................... 20 2 The National Centre of Oncological Hadrontherapy
The National Centre of Oncology Hadrontherapy (CNAO) of Pavia represents one of the most qualified realities in the world landscape of clinical and research activities in this particular form of radiotherapy. For the first time a machine has been built in Italy whose features are specifically suited to treat cancer rather than to perform physics experiments. CNAO has been planned, built and started to meet the National Health System need to treat approximately 2500 new cancer cases per year, for which hadrontherapy has indications, and which otherwise should be treated abroad, with much greater economic burdens. To ensure accessibility for these patients, since the experimental phase the CNAO Foundation has strongly committed in the implementation of a network with the main scientific companies operating in various specialised fields of Oncology (AIRO, AIOM, AIOCC, the Rare Cancers Network and others), and the most qualified clinical entities existing in various Regions. Clinical trials, first with protons since September 2011, and then with carbon ions since November 2012, has allowed to translate these elements into oncology practice and to successfully treat the first patients. The CNAO Foundation is well recognized at the International level and has collaborative relationships with major hadrontherapy centres, notably with the NIRS Centre of Chiba, Japan, where the largest clinical experience in treating with carbon ions has been realized. The CNAO Foundation, besides what is described above in terms of clinical activities, plays an important role for the development of research. CNAO was the co‐ordination Centre of the ULICE (Union of Light Ion Centres in Europe) project, funded by the European Union, involving 20 internationally renowned cancer institutes. It participates in several research projects on optimization of hadrontherapy techniques and allows students and researchers to study hadrontherapy issues. "The results of the treatments so far made with protons and carbon ions confirm the doctors’ predictions and the expectations and hopes placed in this innovative technique. The treatments are painless and, thanks to the introduction of carbon ion beams, besides greatly enlarging the spectrum of treatable diseases at CNAO, it will be possible to reduce the number of sessions needed to treat patients. Hadrontherapy can be used in the treatment of sarcomas, paediatric cancers and lung cancers, as well as liver, pancreatic, prostate, eyes, salivary glands, brain, spinal cord cancers and some head and pelvic area cancers". Roberto Orecchia Scientific Director
3 NATIONAL CENTER OF ONCOLOGICAL HADROTHERAPY CNAO (National Centre of Oncological Hadrontherapy) is an innovative and technologically advanced structure, created with the aim of treating patients with solid tumours by use of protons and carbon ions, particles called hadrons (hence hadrontherapy). In the experimental room, in the dedicated areas and laboratories clinical, radiobiological and translational research activities are performed. For the design, implementation and management of CNAO, the Ministry of Health established the CNAO Foundation in 2001, a partnership and non‐profit Foundation. THE QUALITY POLICY ‐ THE MISSION AND THE VALUES OF CNAO CNAO is a structure operating within the National Health Service (in compliance with ISO 9001 and ISO 13485) and also acts through partnerships of excellence in the healthcare and research environment. Patients are referred to CNAO through a network connecting it to the national healthcare environment. On the basis of defined and shared clinical protocols patients are pre‐selected and referred to CNAO for the treatments, maintaining the link with the initial healthcare structures. The Quality Policy represents and expresses the Directorate purposes and aims at giving instructions in the field of quality for services and processes. 4 Our MISSION The National Centre of Oncological Hadrontherapy (CNAO) was created with the goal of treating tumors by using protons and carbon ion particles belonging to the category of hadrons. The CNAO Foundation is also a Centre of Research and Development, whose activities range from clinical and radiobiological research to translational research with the objective of providing continual improvements in the capacity to cure. Our VISION CNAO aims to excellence in the treatment of oncological pathologies by means of hadrontherapy, research and technological innovation. Our VALUES An organization does not live without values. Not only because values are the cultural and emotional pillars on which the organisation is funded, but, above all, because an organization in as much as a living, therefore operating Entity, cannot but produce values. Values are the ideal meanings having the function of orienting the individual and collective action and of assessing the correspondence to norms assumed as "valid". CNAO main values are: BELONGING (FEELING OF) ACCOUNTABILITY EXAMPLE (CONSISTENCY WITH VALUES) TENSION TOWARDS THE GOAL MERITOCRACY PERSON (CENTRALITY OF) CARE IMPLEMENTATION GROWTH ‐ DEVELOPMENT (PASSION FOR) GROUP (WORKING AS/IN) AVAILABILITY CNAO Foundation Directorate commits to:  comply with regulations and requirements as foreseen by European Law 93/42/CEE, as subsequently amended and supplemented, in the field of medical devices put on the market;  set targets and measurable indicators, during the periodic review performed by the Directorate in order to adequately monitor its own Organization;  communicate and share targets with all the CNAO personnel;  implement and maintain the System of Quality Management, i.e. the entity which purpose is to control and monitor the processes progress and, consequently, the Foundation progress;  disseminate and support the Quality Policy by means of the resources and facilities, constantly monitoring its application and compliance;  motivate every person in the Foundation to promote initiatives and ideas aiming to pursue objectives consistent with the Foundation improvement. 5 HADRONTHERAPY A new frontier of radiotherapy is represented by hadrontherapy which uses protons and carbon ions. The benefits of hadrontherapy with respect to traditional hadrontherapy are primarily represented by the ability of these particles to selectively damage the tumour tissue, sparing the healthy tissues surrounding the tumour. The damage is indeed relatively modest in the first part of the path of the particles inside the tissues and only at the cancer seat there is a significant release of energy, with the advantage of minimising the destruction of healthy tissues and maximizing the diseased tissues. Moreover the energy release mechanism for hadrons, particularly carbon ions, causes a great deal of breaks at the level of the DNA bonds. This latter has an inherent self‐repair capacity that it loses if the number of broken bonds is excessive. Thus the cell, losing its ability to self‐repair can no longer replicate without control and will be submitted to a mechanism called "apoptosis or cell death”. This feature is crucial to destroy especially radio tumours resistant to therapy with X‐rays. Given its recent entry in the oncological environment, hadrontherapy has well‐established indications still limited to a small number of diseases. However the results are increasingly encouraging and increasingly numerous are the pathologies treated with hadrontherapy. CLINICAL ACTIVITY The CNAO Foundation staff works to ensure diagnosis, treatment and patient assistance. The patient referred to CNAO is examined in the Centre surgeries by medical doctors of the structure. Following the confirmation of the diagnosis, the patient is taken in charge by the CNAO Oncological System and is provided with appointments and information to follow the full therapeutic process: imaging sessions, preliminary to the elaboration of the treatment plan, hadrontherapy sessions, check‐up exams and follow up of the treatment. The easiest way to have a preliminary explanation and to evaluate the usefulness of a direct advice in CNAO is sending via email a detailed clinical synthesis, where the most important information are: 
diagnosis (histological examination); 
the report/s of radiological investigations (TAC and/or RMN and/or PET, other), if any; 
occurring, current or proposed treatment. If, because of its characteristics, the proposed clinical case is judged to be eligible for hadrontherapy and compatible with clinical‐therapeutic pathway in CNAO, the patient is contacted at soonest for an exam in our Centre. If, because of its characteristics, the proposed clinical case is not eligible for hadrontherapy, the Medical Service, after receiving all the documentation, takes care of sending the patient an exhaustive answer. Documentation received by CNAO corresponding to a not eligible patient is destroyed after 30 days from the transmission of the answer. In case the received documentation is the original one, the reference medical doctor takes care of forwarding it to the Secretariat staff so that it is re‐transmitted by mail, making sure it has been duly been received. 6 The medical service can be contacted by email, postal and fax service at the following address: FONDAZIONE CNAO Medical service Strada Campeggi 53, 27100 Pavia e‐mail: [email protected] Fax: +39 0382‐078903 From 9:00 to 16.00 from Monday to Friday the following telephone number is operational and reserved to patients and to those who wish to receive further information about the clinical activity of CNAO: Medical information Secretariat Tel: +39 0382‐078963 The functions provided within the structure can be sketched according to the following functional sectors: •
multiple outpatient service; •
imaging service (image diagnostic and nuclear medicine); •
hadrontherapy service. The Outpatients' Clinic Like other services that are strongly attended by users, it is located on the ground floor near the main entrance. It consists of six outpatient spaces, adequately equipped to handle with possible emergencies. There is a space reserved to the stops of the patients on stretchers near the outpatient area and inside the "clean" area. Periodic visits for initial consultation are carried out by radiation oncologists, usually on Tuesday, Wednesday and Thursday from 9:30 to 13:00. Periodic follow‐up visits are carried out by radiation oncologists, usually on Monday, Tuesday, Wednesday and Thursday from 14:00 to 16:00. Radiation oncologists visit patients also in private practice from Monday to Thursday, starting from 17:00 o’clock. 7 The diagnostic imaging and nuclear medicine service Carrying out exams with medical diagnostic equipment represents the first step in the path of the hadrontherapy treatment. At CNAO clinical examinations are performed in order to accurately identify and select the tumour target and to surround the healthy tissues to be spared. Hadrontherapy allows to reach a high degree of accuracy in the release of the dose to the tumour and therefore requires medical diagnostic tools of great precision to obtain adequate accuracy to detect the cancer location. The most innovative diagnostic modalities have been introduced in CNAO, a computerized axial tomography (TAC), a magnetic resonance imaging (MRI) and CT‐PET tomography device, with the relevant image fusion programs. The service is located on the ground floor. Diagnostic radiology (MRI and CT SCAN) sessions are preferably held on Monday and Friday from 8:00 to 18:00; while nuclear medicine (PET‐CT) sessions take place preferably on Tuesdays from 08:00 to 17:00. The hadrontherapy service area The basement of the hospital structure is substantially reserved to the treatment of patients. The waiting room, naturally receiving the light from the central courtyard glasses of the building, is adjacent to the area reserved to the treatment simulation and the treatment itself. The treatment area is organised in several zones with separate functions. From the waiting room the users are directed, through dressing rooms and the distribution corridor, to one of the three preparation rooms. From here they are sent to one of the three treatment rooms. 8 Users on stretchers, arrived at the ground floor using the lifts reserved to stretchers, make a stop in a special room located in a barycentre position relative to the area where staff rooms are distributed, the service spaces (stores, toilets, medicines), a fully equipped outpatient space for emergencies and a post‐treatment space where patients stop before leaving the unit. The Radiotherapy treatments unit opening hours are normally from 08:00 to 21:00 on Mondays to Fridays. The Reception service is operational from Monday to Thursday, from 8:00 to 18:00 and on Fridays from 8:00 to 17:00. Reception Service tel. +39 0382‐078305 mail: [email protected] The therapeutic clinical path  Preliminary clinical path – programming treatment plan The radiotherapist schedules a series of exams (preliminary clinical path) in order to gather more information on the morphological and functional features of the tumour and sets at best the treatment. The exams allow the doctor to define the geometry of the most advantageous and most appropriate positioning of the patient for a more effective delivery of the hadrontherapy treatment. The radiation oncologist prescribes the following diagnostic investigations: • • • • CT SCAN (Computerized Axial Tomography); MRI (Magnetic Resonance Imaging); TAC‐PET (combined apparatus of computed tomography and positron emission); additional investigations within external Centres. Such tests, whenever made at the CNAO Foundation plant, are programmed by the radiation oncologist. The doctor responsible for the diagnostic exam takes care of having the patient sign his consent; the radiation oncologist responsible for the patient checks that the file contains the informed consent about the prescribed tests, signed by the patient. The patient is submitted to the prescribed exams at the CNAO Foundation, followed directly by the nurses and the staff of the Diagnostic Imaging Unit. The tests done and the corresponding medical reports are collected in the medical file under the care of the radiation oncologist who may, at his own choice, schedule any further investigations/specialist visits.  Treatment Plan Elaboration The patient's care plan is the result of the cooperation work between the Clinical Radiotherapy Unit and the Medical Physics Unit and is the synthesis of the diagnostic information resulting from the prescribed exams. In the Care Plan the following entries are specified, among others: 
the dose per fraction and the total dose to be delivered to the patient; 
the number of fractions; 
the beam parameters that the accelerator will deliver depending on the location of the cancer. The characteristics of the care plan, in terms of risk of toxicity to healthy organs adjacent to the tumour, are explained to the patient prior to the start of hadrontherapy cycle and possibly completed in writing with the informed consent. 9  Treatment Cycle using Hadrontherapy The patient is submitted to the hadrontherapy cycle as defined in the Plan of Care signed by the medical physic expert and the radiation oncologist. Treatment is delivered according to the requirements defined in the approved clinical reference protocols. Nurses, radiology technicians and the radiotherapist accompany the patient during the entire duration of the treatment. Access to areas and patient preparation is performed in accordance with the reference Protocol. The radiation oncologist regularly makes weekly outpatient visits during the course of the treatment, scheduling, where appropriate, any additional exams and/or specialist visits.  Treatment End The patient, at the end of the treatment cycle, is visited by the radiation oncologist who prepares the end of treatment report. This is produced in double copy, one is delivered to the patient and one is attached to the clinical file. The data collection sheets laid down by the Protocol of clinical investigation are compiled by the radiation oncologist.  Patient Follow up At the end of the radiation treatment the radiation oncologist schedules radiological controls and follow‐up visits to be made at the CNAO Foundation according to the timetable foreseen by the clinical protocols. Follow‐up visits are meant to test the tolerance to the treatment and the effectiveness of the service provided. Recognizing CNAO health‐care staff All the persons working at the CNAO have an identification card containing: name, role, photography and a coloured band that identifies the clinical Department. The healthcare staff is marked by: Role Colour Physician Nurse HealthcareTechnician Medical Physicist Bioengineer Nuclear Medicine Staff OSS (Care Technician) Outfit White coat White jacket and whit trousers Green jacket and pants and white coat with green border White coat with blue border White coat with blue borders Outfit (correspondent to the professional status) with orange border Light blue jacket and pants 10 RESEARCH AT CNAO Clinical Research The clinical activity of the CNAO Foundation is to be considered at 360 degrees as research activity. All patients treated at CNAO are included in clinical protocols approved by the Ministry of Health. The "protocols" are a series of "rules" describing the characteristics of the persons who can be cured within a clinical activity: the programme, the logistics, the necessary exams., the details about care and length of the study. In order to verify that a person’s disease is eligible to be part of a protocol an accurate selection is foreseen; it aims at defining whether all its requirements are met. Such requirements are necessary to identify the most eligible persons and to ensure similar results without any discriminatory intent. Before being inserted into a protocol the patient is properly and fully informed by the medical doctors and then releases his free and informed consent to participate. Clinical research made by the CNAO Foundation is dedicated to the treatment of solid tumours resistant to conventional radiation with X‐rays. High‐ Technology Research The pre‐clinical research activities are on the other hand those which do not foresee the patients’ involvement; they are related to studies on objects or cells. These research activities are carried out in collaboration with Italian and foreign researchers. Technological developments are focused on the continuous improvement of patient and beam handling in order to make hadrontherapy available in an increasing number of cases and with more and more effective features. Additional pre‐clinical research activities include studies of the biological effects of radiation which are made by irradiating different types of cells in different conditions. These studies will allow to better fit therapy to the patient by choosing each time the dose to be delivered, the fractionation and the most suited particle type. All endeavours are made for attaining a more targeted therapy, adapted to each individual patient. 11 The experimental line With the purpose of consolidating and growing the excellence role of CNAO, investments should be granted in the field of research and development, in order to make it a reference standard with an absolute value in a global framework of increasing interests in hadrontherapy. The ongoing realization of the experimental beam line, in collaboration with the INFN, represents a key point in this direction, since it assures the possibility of performing pre‐clinical research activities in several and different fields, in a completely dedicated area equipped with laboratories, with an independent access and beam time availability. The realization of the new beam line, as represented in the following figure, has started in the Summer of 2014 and its completion is foreseen for 2018. Sketch of the experimental beam line under construction at CNAO. 12 In the first realization phase the beam characteristics will be very similar to the ones available in the treatment rooms. In the experimental beam line a beam with a mobile isocentre will be available in order to improve flexibility and to adapt the existing space to the several different experimental configurations. The beam line will undergo a future optimization, foreseeing the implementation of a third source devoted to new ion species test. PATIENT RIGHTS The ill person addressing to our Centre has the right to: 
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receive medical‐nursing treatment that does not discriminate people on a gender basis, on census or on religious and political convictions, inspired by the respect for human dignity; obtain accurate and understandable information on their state of health, on the outcome of the performed investigations, on the proposed therapy and any alternative therapies; give their consent or dissent on the diagnostic therapeutic program proposed by the medical doctors in the respect of the right to their involvement in the choices; guarantee themselves access to appropriate assistance that matches the requirements of effectiveness with those of efficiency; rely on reporting of information on themselves and on their family members in respect of the right to privacy; be able to identify the staff with whom they deal; receive punctual answers and clarifications; be received in an organization which strives to ensure the respect of safety; the removal of physical, cultural and linguistic barriers, the protection of patients who are in situations of fragility, even temporary and which takes into account the patients’ values and habits; be assisted in an organised centre that cares for the patient’s needs; the service is provided on the basis of diagnostic‐therapeutic procedures structured on evidence of effectiveness; the activities are organized in view of ensuring continuous assistance when possible. Information The patient has the right to access all types of information concerning his state of health, to diagnostic tests and therapeutic treatments which must be undertaken. CNAO has consequently adopted a policy of information and education, for the involvement of the patient and his family in the decisions concerning his health.  Informed Consent The patients have the right not to be submitted to any care or treatment without having expressed their consent. CNAO releases an Informed Consent Form to the patient, to be completed before being subjected to the procedure, different for each service that requires its use, which includes the execution mode, the risks and possible side effects. Informed consent must also be required from the patient in the case his clinical case is chosen for use in research or teaching.  Exam Preparation and post examination information Whenever the diagnostic exam requires preparation, a sheet will be issued upon booking, describing its modalities. Whenever the diagnostic exam, once done, involves a therapy to be followed over time, the patient is provided with all the necessary information. 13  Clinical report The CNAO commits to release a clear clinical report, written in an understandable language and complete with all the information about the diagnosis and treatments performed.  Medical Records Copy Request A copy of the medical record can be requested and collected only by the holder of the same medical records upon presentation of appropriate proof of identity. Alternatively it can be requested by a person bearing written delegation and a copy of proof of identity of the holder of the medical record. To obtain a duplicate of the clinical documentation an appropriate form must be filled out. Delivery of the medical record copy takes place within 30 working days after the request.  Healthcare Staff Identity The right to information includes the patients’ right to know the name of the doctor to whom they are assigned and to know the identity, status and role of the healthcare assistants. Inside the CNAO each member of the medical staff and of the entire structure is identified by a visible badge. In addition, the various sections of the structure where the different services are provided are signalled with a clear and obvious labels.  Non‐executable Service In the event of temporary impossibility to provide the service, the patient will be contacted by phone or by SMS. It remains CNAO's responsibility to contact the patient as soon as it is ready to schedule a new appointment.  The right to obtain explanations The patient benefiting from services provided by CNAO has the right to request at any time the intervention of a doctor to obtain explanations on the examination, its preparation and results.  Foreign Patient Foreign patients must have with them:  identity card, valid passport or equivalent identification document with photo;  form S2 for patients of the European Community;  form STP (Temporarily Present foreigners) for extra‐Community patients. Conventions Agreements for outpatients' services with most of the bodies managing health policies and the sector Mutual Benefits are operational, for further information please contact the Reception service. Privacy The patient has the right, in accordance with the D.Lgs. 196/2003, to the maximum of confidentiality on personal data and on those related to his medical record. Healthcare staff and administrative staff of the CNAO forge their actions in respect of the secrecy and confidentiality of information of which for professional reasons they may have become aware of. 14 Protection  Patients Protection CNAO avails of an Ethics Committee (EC), which has the responsibility of ensuring the protection of the rights, of the safety and the well‐being of those who decide to join it for any clinical trials and treatment protocols of experimental nature.  Public relations The Customer Service responsible persons have the task of receiving from Users any type of information, comment and complaint concerning the service. At the patient’s request, the front office staff is delegated to contact the Responsible on duty, who reaches the patient and has the task to receive the patient’s statements and to intervene directly to resolve the situation, by choosing the most suitable one. The Director will periodically analyze the relationships of the responsible persons solving the problems that may have risen.  Complaints about the service CNAO intends to give a quick and fair response to all complaints expressed by users. In fact, CNAO is ready to know the level of satisfaction of its customers through the analysis of the complaints in order to evaluate their causes and nature, to prevent them and reduce their number. The complaints may be received by fax, by phone, by letter or in person. Periodically the analysis and assessment of the claims received is performed so as to prepare appropriate improvement actions.  The patient's goods We recommend patients to take care of their personal belongings: CNAO will not be responsible for any damages or thefts experienced by patients while staying within the structure. However, the Centre provides each patient a locker in which personal effects can be stored during the treatment. Safety  Medical Assistance If necessary clinical assistance to patient is guaranteed by the structure through three progressive levels. a) At the first level of assistance the doctor performing the patient’s procedure (visit, examination, treatment, etc.) is entrusted with the patient who needs some assistance. If the patient is in public areas (bar, corridors, waiting rooms, etc.) we proceed to call the manned room at the phone number 333 asking to find a physician on duty for the first aid. b) At the second intervention level the internal anaesthetist, in case he is in CNAO during radiodiagnostic procedures with medium of contrast, will guarantee assistance. c)
The third intervention level provides the call of Anaesthesia and Resuscitation service of the San Matteo Hospital in cases where the patient's clinical evaluation made by doctor rescuer declares emergency or urgency. The San Matteo Hospital will ‐ within the shortest time possible ‐ send a unit of medical specialists in Anaesthesia and Resuscitation. In the case urgent transfer of a patient from CNAO to the First Aid Service of the Hospital San Matteo is needed, this will, in the shortest time possible, through its Internal Transportation Service provide for an ambulance with 1 nurse and 1 rescue driver. 15 CNAO, as an outpatient structure, does not have a resuscitation service. To make up for this gap, in cases where the activation of the second level is foreseen, and in order to give the patient the best possible assistance, some members of staff (doctors, nurses, technicians) have been trained through BLS and BLS‐D courses in order to support the doctor available during the process of second‐level service.  In the event of an emergency (fire, flood etc.) CNAO's staff is trained to intervene in emergencies and to protect patient safety.  Surveillance Service The plant premises are monitored by a video‐surveillance system and security guards controlling the Centre 24 hours on 24. Recognition of physical/architectural barriers and protection CNAO has designed its rooms and its services, carefully avoiding the presence of architectural barriers. The structure protects and meets the needs of the elderly, minors, disabled people, people with disabilities and with walking difficulty:  entrances: there are preferential paths and an entrance reserved for patients on stretcher;  sloping levels: they can be overcome with lifts or stretcher trolleys;  doors: there are doors only for ensuring privacy, security or regulated access to protected areas;  lifts: stand‐alone operation is guaranteed for wheelchair users;  toilets: specially designed services are available in each area. Smoke By legal regulations, smoking is strictly forbidden in any CNAO space. RIGHT TO SUBMIT SUGGESTIONS OR COMPLAINT The patient or family member, who wants to report a complaint about the service offered by the CNAO, may use the form "Claim‐Patient Report", available in the message boards of CNAO and placed near the waiting rooms areas. From patients forms are sent to the Communications Office and the Quality Manager who analyzes them in connection with the relevant functions and takes action to improve the service. Questionnaires Kindly take a few moments to fill out the questionnaire "Patient Satisfaction", and express with the greatest freedom, sincerity and anonymously, your opinion. Questionnaires can be filled out in paper format (you find them in the message boards of the CNAO). The questionnaires are periodically analyzed by the Communication Office and contribute to making our Centre increasingly satisfactory to meet the patients’ expectations 16 CNAO SEATS CNAO operational seat is located in Pavia, Strada Campeggi 53, where the administrative, outpatient, imaging and patient treatment activities are concentrated. HOW TO REACH US Train Pavia train station is on the Milan‐Genova line. The journey from Milano central station lasts on average 25 minutes. For more information: www.trenitalia.it The CNAO Foundation is 10 minutes away from Pavia with city bus (line 3 or 7) or taxi. Plane E. Forlanini‐Airport ‐ Milan Linate There is a bus connection with Pavia with the bus lines Migliavacca: tel. 0382.525858, which drives to Pavia train station. Milan Malpensa Airport There is no direct connection by bus with Pavia. Using the Malpensa Shuttle you can arrive at Milan's Central Station and take a train to Pavia Bus Urban public transportation in Pavia is managed by LINE S.p.A. Direct lines to our Centre are no. 3 (direction Maugeri/Colombarone) or no. 7 (direction Maugeri/Mondino), the stop is Taramelli Forlani (fifth stop from Pavia station). From the bus stop the entrance to the CNAO is 300 metres away and is indicated by road signs. Taxi Taxi service is available at: • Piazzale della Stazione‐tel. 0382.27439 • Piazza Vittoria‐tel. 0382.29190 • Piazzale Golgi ‐tel. 0382.52628 • Radio Taxi‐Tel. 0382.576576 Car Motorway Milano‐Genova A7 Exit at “Pavia Nord‐Bereguardo" and follow the signs to "Istituti Universitari ". Turin‐Piacenza motorway A21 Exit at "Casteggio‐Casatisma", and take the SS35 – Statale dei Giovi ‐follow the directions to Pavia Centre and then signs for "Istituti Universitari". Parking space Inside the CNAO Foundation there is an area devoted to parking. For patients you can use the dedicated space until exhaustion of places. 17 CNAO Foundation does not take any responsibility concerning damages to or missing objects from cars left in the CNAO parking. OVERNIGHT STAY The Foundation has no hospitalization service but you can stay in hotels or reception facilities. Below is a list, not exhaustive, of accommodation facilities in the territory of Pavia. This list is provided for information purposes only. The CNAO Foundation shall not bear any liability. ANPO – National Oncological Prevention Association via Monferrato 9, 27100 Pavia Tel. + 39‐0382‐52.96.84 ROOM TYPE: apartment COST: offer ROMAN CATHOLIC DIOCESE OF PAVIA – CASA DELLA CARITÀ Via Pedotti 14, 27100 Pavia Tel. + 39‐0382‐23,138 ROOM TYPE: room with bathroom COST: offer Services: dinner THE PARISH OF SS. CRUCIFIED – CASA BETANIA Via Suardi 6, 27100 – Pavia Tel. + 39‐0382‐47.10.40 ROOM TYPE: room with bathroom REGINA PACIS IMMACULATE MISSIONARY SISTERS Via Golgi, 27100 Pavia Tel‐49. + 39‐0382‐52.57.19 ROOM TYPE: room with bathroom Cost: 25 € per person RESIDENCE FANNY – FOUNDATION BARBARA FANNY FACCHERA ONLUS The Fanny Residence is a protected social health care facility dedicated to patients and their families. The services offered, in addition to the reception always active are: apartments and facilities sanitized, medical study, free shuttle bus. Viale Brambilla, 70/D – 27100 Pavia Tel: +39‐0382‐52.52.22; Cell. +39‐328‐42.55.929 RESIDENCE LA SFERA(preferential tariff) La Sfera Residence offers apartments of various types that, furnished with care and elegance, offer a comfortable stay for overnight, short and long periods. Via Breventano, 22 – 27100 Pavia – Tel: +39‐0382‐18.61.620 www.residenzialelasfera.it ‐ [email protected] PAVIA RESIDENCE (preferential tariff) Via Coralli 9 – 27100 Pavia – Tel. +39‐0382‐52.67.83 Cell: + 39‐337‐11.04.958 www.paviaresidence.it ‐ [email protected] Viale Brenta, 3 ‐ 27100 Pavia ‐ Tel +39 (0)382 52 88 65 Cell. +39 338‐2814964 www.paviaresidence.it ‐ [email protected] 18 RENT ROOMS PAVIA Viale Golgi, 40 – 27100 Pavia – Tel. +39‐0382‐86.29.57 Cell: +39‐348‐82.85228 www.affittacamerepavia.com ‐ [email protected] PAVIA RENT ROOMS Via Giovanni Rasori, 1 – 27100 Pavia ‐ Tel +39 (0)382 52 67 83 ‐ Cell. +39 337 11 04 958 www.paviaaffittacamere.it ‐ [email protected] RESIDENCE PARVA URBI(preferential tariff) Viale Brambilla 70/d – 27100 Pavia – Tel: +39‐0382‐24.218 Cell: +39‐334‐29.00.856 www.residenceparvurbipavia.it ‐ [email protected] RESIDENZIALE IL NAVIGLIO (preferential tariff) Via Rismondo 64/66 – 27100 Pavia – Tel. + 39 0382 1753833 ‐ Cell.: +39 3391996210 www.ilnaviglio.com – [email protected] CASA MIMMA (preferential tariff) Via Beccaria – 27100 Pavia – Cell.: +39 335 – 6234824 www.casamimma.com – [email protected] B&B PAOLA E FRANCESCO (preferential tariff) Via Gramsci, 50 – San Martino Siccomario – Cell.: +39 339‐4518048 www.paolaefrancescobadandbreakfast.it – [email protected] RESIDENCE ISOLA VERDE Via E. Tibaldi, 15 ‐ 27100 Pavia (PV) ‐ Tel. (+39) 0382 529439 http://www.isolaverdesrl.it ‐ [email protected] GUEST HOUSE MAIOCCHI V. the Golgi, 27100 Pavia Tel‐42. + 39‐335‐53.11.527/+ 39‐328‐63.93.588 Cost: single room without breakfast € 40 Double room without breakfast 50 € HOTEL ROSENGARTEN *** (prices may vary depending on the season) Via Cesare Lombroso, 21/23 27100 – Pavia Tel. + 39‐0382‐526312 Single room including breakfast 64 € Double room including breakfast 90 € HOTEL MODERNO **** (prices may vary depending on the season) Viale Vittorio Emanuele, 41 27100 – Pavia Tel. + 39‐0382‐303401 Single room including breakfast 105 € Double room including breakfast 135 € HOTEL EXCELSIOR *** (prices may vary depending on the season) Piazzale Stazione 25 27100 – Pavia, Tel. + 39‐0382‐28596 Single room including breakfast 65 € Double room including breakfast 90 € 19 HOTEL AURORA ***(prices may vary depending on the season) Viale Vittorio Emanuele II 25 27100 – Pavia Tel. + 39‐0382‐23664 Single room including breakfast 80 € Double room including breakfast 95 € FOOD SERVICE MARKAS MENSA (preferential tariff) via Ferrata, 20 – 27100 Pavia (PV) – Tel. 0382/529682 CAR RENTAL SERVICE AUTONOLEGGIO BOGGERI (preferential tariff) Via Liutprando, 6 – 27100 Pavia telefono e fax 0382.25222 [email protected] For further details about structures assuring preferential tariffs, please contact the Reception. SUPPORT US The mission of the National Centre of Oncological Hadrontherapy aims at offering a valid contribution to the fight against cancer. Hadrontherapy represents one of the most powerful and effective radiation therapy techniques in treating tumors “resistant” to commonly used radiotherapy and in decreasing collateral effects, improving so the treatment options and the patients quality of life. Donations could be performed by means of bank transfer Bank name: UBI BANCA Account name: Centro Nazionale di Adroterapia Oncologica. IBAN code: IT 64 J 03111 11300 000000048861 BIC/SWIFT BLOPIT22 Versione 08/2017 – May 2017 20 An institution with managing system for quality
ceertified UNI EN ISO 9001 and UNI EN ISO 13485
Strada Campeggi 53 - 27100 Pavia
Tel +39 0382 0781 - [email protected]
P.I. 03491780965
www.fondazionecnao.it