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The Sky Is The Limit

Quality monitoring breathed new life into this emergency nurse’s career and catapulted two EMS centres in Tuscany onto the international awards stage. The good news is, Cristina Riganti is not done learning and growing.
Angels team 04 September 2023

Cristina Riganti became an EMS nurse for all the right reasons.

“I was looking for the right setting in which to express myself,” she says. “I needed an environment that would offer high and constantly growing areas of autonomy, and the potential for acquiring specialised and highly complex skills.”

Cristina took advantage of all the opportunities her career offered. On top of her nursing degree she earned qualifications in emergency and disaster nursing, in criminology, investigation and security sciences, and in health management and coordination. She also completed courses in advanced resuscitation and in basic life support and defibrillation.

Her job at Centrale Operativa 118 Firenze-Prato, which she joined in 2014, afforded her experience in ambulance nursing as well as working at the dispatch centre, and provided such highlights as working in the operational base of Toscana Soccorso, which deals with the activation and management of the three rescue helicopters of the Tuscany region.

But about three years ago, Cristina was experiencing something of a mid-career malaise. Although her days continued to be characterised by urgency and action, she was experiencing a crisis that affects many successful people in enviable careers – the lack of stimulation and the need for growth.

Fate intervened when she was invited to speak at a stroke pathway seminar at Firenze’s Hospital Santa Maria Nuova, the clinical home of radiologist Dr Angela Konze, director of neuroradiology in Central Tuscany who in 2022 would received the prestigious ESO Spirit of Excellence Award.

Dr Konze had become fascinated by the Angels Initiative in 2017 after a conversation with former ESO President Prof Valeria Caso. The consultancy that followed helped
Santa Maria Nuova halve its door- to-treatment times and double its treatment rate in under a year, and thanks to Dr Konze and ED nurse Rita Marino’s enthusiasm for the initiative, their hospital became a bright spot that continued to spread its light.

The seminar marked a turning point in Cristina’s career. She says: “From the moment I met Angela and Rita, in addition to a great friendship, a very strong professional collaboration was born.”

An opportunity to attend a stroke workshop and simulation training at Santa Maria Nuova deepened Cristina’s interest in stroke. She also met Angels consultant Lorenzo Bazzani with whom she raised opportunities to improve the prehospital stroke care provided by Tuscany’s 118.

MonitorICTUS, Italy’s quality monitoring project of the prehospital pathway, had just been launched. After consultation with the directors of the dispatch centres in Firenze-Prato and its neighbour Empoli-Pistoia, both centres joined the project, with Cristina adding data collection and reporting to her work responsibilities.

Dr Angel Konze and ED nurse Rita Marino have been catalysts in Cristina’s career evolution.

EMERGENCY nurse Cristina Riganti became involved in quality monitoring for all the right reasons.

“She’s both very passionate and very precise,” says Angels consultant Alessia Santori. “The time-dependency of stroke resonated with her dynamic personality, and she saw an opportunity to make a difference.”

That difference was already quantified by the end of 2021 when Centrale Operativa 118 Firenze-Prato met the criteria for an EMS Angels platinum award. Not long afterward, family commitments required a move to Empoli-Pistoia where Cristina became involved in the revision of the operating instructions for the adult stroke path and drafting procedures for the pediatric stroke path. Her expanded role made it even more satisfying when Empoli-Pistoia reached platinum status at the end of 2022 and became a diamond winner at the start of 2023.

It was a clear-cut demonstration of the positive impact of quality monitoring, which Cristina acknowledges is “an excellent tool for stroke care improvement because it doesn’t only measure the outcomes achieved but makes it possible to identify and address the causes of unsatisfactory results”.

Professional growth came at some cost. Collecting data for two dispatch centres amounted to hours of extra work, leaving less time for participating in endurance sports with her partner, or leisure pursuits such as furniture restoration or painting. But Cristina weighed the benefits and costs and made a decision that favoured patients.

She says, “When making a commitment, I first analyse all the variables to evaluate whether it is feasible. In the end it was enough to dedicate a few more hours a month, and when it came to achieving important goals for the patient’s health, it was worth it.

“I carved out time for this project, and today I can say I am proud of it.”

Stroke care quality monitoring has expanded Cristina’s professional horizons but when it comes to growth, it turns out that the sky is literally the limit. Joining a helicopter rescue team is next among the emergency scenarios she still wants to explore, and she is working towards a qualification in risk and disaster management that she hopes will help her land a position in this competitive field.

“It’s not an easy job contest to win but I’ll study hard to get there,” she says. “I would also like the opportunity to work a few shifts in a hospital emergency room to gain a 360 degree view of emergency activation. As I said, I’m very passionate about my work and I don’t want to stop learning and growing.”


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