‘The mountain of paperwork after tissue retrieval is a thing of the past’

Annet Varkevisserhas been working at WUON since 2021 and speaks proudly about Delta, the new application that has digitized the tissue retrieval process.

Wouter Flemmingis a project manager at the NTS and was involved in the integration with the NTS systems.

Paper-based process

Annet: When I started at WUON in 2021, I mainly encountered a paper-based process. The assignment from the NTS did arrive by email, but that was it; that was where the automation ended.

For every procedure, multiple forms have to be filled out. For a major procedure, this might mean entering a donor number and date of birth up to 18 times. That is intensive, because the team works under difficult conditions. You have to imagine them standing in a hospital morgue, often in the evening or at night.’

Maintaining an overview on a peak day

‘There are nearly 100 explantation staff members working in various teams at WUON. That is necessary, because tissue donation cannot be planned in advance. Days with 14 donors spread across the entire country are no exception. Multiple teams head out at the same time, constantly keeping each other updated. Especially on such peak days, it is difficult to maintain an overview with a paper-based process.’

Moving towards integrated digital systems

‘Fortunately, that need for oversight and digitization existed throughout WUON as well. In 2022, we took the first concrete steps toward automating the process. We found a partner to build a new web solution, called Delta. We also involved the NTS in our plans. Ultimately, we went live with Delta on April 4, 2024.’

Impact on the entire chain

‘This automation effort has a significant impact on the entire chain. It is important that we provide data that is complete and reliable. Upon a donor notification, the NTS provides master data. Everywhere in the procedure where this data is needed, it is now filled in automatically. And a major advantage for the chain is the real-time availability of retrieval data. Through Delta, tissue banks receive information about the tissue they are going to receive at an early stage, allowing them to anticipate it. The NTS can also share information with a notifying physician much sooner.’

Wouter also sees the added value and adds: ‘Support from an application is only optimal if it delivers value throughout the entire process chain. In this case, a direct link ensures that there are no more error-prone transfer moments. Our retrieval assignments lead directly to the initiation of a task in Delta. And all explantation data arrives almost immediately in our Vita system for processing.’

Greater job satisfaction

Annet: ‘And very importantly: the job satisfaction of the retrieval team has increased enormously. Previously, it could happen that a team retrieved tissue in Groningen, then drove on for a retrieval in Assen, and had a third donor in Apeldoorn on the way home. After such a long day, they had to get all the paperwork in order at the office for transport to the tissue banks and enter everything digitally.’

‘This is no longer necessary; everything is already entered upon return. Even the inspection drawings. The overall overview that Delta offers gives the teams peace of mind. Delta is also structured in such a way that the teams are guided through process steps. All in all, important aspects to optimally support the teams' work.’

Nice side effects

‘On paper, there is a clear scope for such a project, but in practice, you often encounter gray areas. For example, we saw that for tissue rejection reasons, a lot was registered under the category ‘other’.’

‘After analysis, we added some more frequent procedural rejection reasons. And we added, for example, ‘weather conditions’. You might not think of this quickly, but during the floods in Limburg in 2021, tissue retrieval in that region could not proceed everywhere. By including more specific rejection reasons, you get more insight into them and can perhaps do something about them in the intake. So those are nice side effects. This is how we work together on better and more reliable analyses.’

Good cooperation is crucial

Annet: ‘I am happy with how it has gone and is still going. We are realizing the data link together with the NTS. Once this is finished, we will receive the data directly from Vita. That is, of course, fantastic. It is precisely through such a project that you get to know colleagues from another foundation well. Not all deadlines were met, but we all see the urgency and would rather have it live today than tomorrow. We now know how to find each other, also for other projects in the tissue chain. That is truly valuable.’

Wouter: ‘WUON connected directly with the NTS at the beginning of its digitization journey. The challenge of such a link is that you have to agree very clearly on what language you speak with each other, and you must also fully understand all possible exceptions.’

Future wishes

Annet: ‘The idea for the future is to make this process more transparent for external parties. A good example is the so-called Estimated Time of Arrival (ETA) of donor tissue at the tissue bank. Having insight into this would be very valuable for the banks.’

Wouter: ‘The implementation of Delta and the data exchange provide the space to record more and more data reliably and user-friendly. In the future, that will provide the opportunity to perform process analyses on even more aspects and to continue improving.’