'The excessive 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 used to digitize the tissue retrieval process.

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

Paper-based process

Annet: When I started at WUON in 2021, I encountered a mostly paper-based process. The assignment from NTS would already come in by email. That was it; automation stopped there.

Multiple forms must be filled out for each procedure. For a major procedure, this might mean entering a donor number and date of birth up to 18 times. That is intensive, as the team works under difficult conditions. You have to imagine they are in a hospital mortuary, often in the evening or at night.'

Maintaining oversight on a peak day

'WUON employs nearly 100 explantation staff across various teams. 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 then go out simultaneously, constantly keeping each other updated. Especially on such peak days, it is difficult to maintain oversight with a paper-based process.'

Towards linked digital systems

'Fortunately, that need for oversight and digitization existed across all of 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 NTS in our plans. Ultimately, we went live with Delta on April 4, 2024.'

Impact on the entire chain

'This automation step has a significant impact on the entire chain. It is important that we supply data that is complete and reliable. Upon a donor notification, NTS provides master data. Wherever this data is needed in the procedure, 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 early information about the tissue they will receive, allowing them to anticipate it. NTS can also share information with the registering physician much earlier.'

Wouter sees the added value as well and adds: 'Application support is only optimal when it delivers value across the entire process chain. In this case, a direct link ensures there are no longer error-prone transfer moments. Our retrieval orders immediately trigger an assignment in Delta. And all explantation data enters our Vita system almost instantly for processing.'

Greater job satisfaction

Annet: 'And very importantly, the job satisfaction of the tissue retrieval team has increased enormously. Previously, a team might retrieve tissue in Groningen, then drive on for a retrieval in Assen, and have a third donor in Apeldoorn on their way home. After such a long day, they had to sort out all the paperwork at the office for transport to the tissue banks and enter everything digitally.'

'This is no longer necessary; everything has already been entered upon return. Even the post-mortem sketches. The comprehensive overview that Delta provides gives the teams peace of mind. Also, Delta is structured in such a way that the teams are guided through process steps. All in all, these are important aspects to optimally support the work of the teams.'

Nice side effects

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

'After analysis, we added a few more frequently occurring procedural reasons for rejection. And we added things like "weather conditions", for example. You might not think of this quickly, but during the floods in Limburg in 2021, tissue retrieval in that region could not take place everywhere. By including more specific reasons for rejection, you gain more insight into them and you might also be able to do something with them during intake. So those are nice side effects. This is how we work together on better and more reliable analyses.'

Good collaboration is crucial

Annet: 'I am happy with how things have gone and are still going. We are realizing the data linkage together with the NTS. When this is finished, the data will be fed directly into our system from Vita. That is fantastic, of course. Precisely through such a project, 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: 'At the start of its digitization process, WUON communicated directly with the NTS. The challenge of such a linkage is that you have to agree very clearly on the language you speak with each other, and you also have to fully understand all possible exceptions.'

Future wishes

Annet: 'The idea for the future is to make this process more transparent for outsiders. A great example is the so-called Estimated Time of Arrival (ETA) of a 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 room to record more and more data reliably and in a user-friendly way. In the future, this will provide the opportunity to perform process analyses on even more aspects and to keep improving.'