‘I can get an incredible amount out of the Kidney Dashboard’

Stefan Berger has always had a passion for numbers. In 2016, he was part of a working group that made all kidney data available in clear tables. This laid an important foundation for the current dynamic Kidney Dashboard. How does he use this dashboard in his work?

Current waiting times at your fingertips

Stefan: ‘Waiting times are important for my work. You want to be able to check them regularly because it is so important when informing patients. They want to know: ‘how long do I have to wait for a kidney from a deceased donor?’ That waiting time is important for them to decide whether they should look for a living donor. If it’s only a matter of a few months, that consideration is very different than if it’s 5 years.’

Comparing with other centers

‘The beauty of the new dashboard is that you can very easily view multiple years to analyze trends. I like to find out how we are doing in our own center, but I am also curious whether we deviate from the national average. Because it only starts to become meaningful when you see what the rest are doing. Sometimes there are temporary fluctuations, but if a center stands out every year, I sometimes approach them about their great performance. I want to know how that works and what their best practices are.’

This center is really fast, how is that possible?

‘In the Kidney Dashboard, I saw that in one center, patients have significantly shorter dialysis times than the rest of the country. I already had an idea of this before, but it is of course great that I can also see this reflected in the Kidney Dashboard. I really want to get in touch with this center one day to understand this. We have the feeling that we are already fast.’

‘I also find it interesting to see how long it takes per center before a post-mortem kidney is placed (cold ischemia time). Especially with DCDs, we think it can be harmful if this takes too long. When you see that colleagues elsewhere do it much faster, I think: ‘Apparently it can be done differently! What is the reason for that?’ If you know that, everyone can learn from it.’

Differences in the older patient group

‘It is also interesting to look at the variation between centers in the percentage of people over 75 that they transplant. This varies from under 1% to about 7%. Apparently, as an older patient, you don't have the same chance of a transplant everywhere. For me, such an observation is not about a value judgment, but I want to know why there is a difference in assessment. There are centers that are willing to take more risks than others; this is no secret. It is interesting to discuss together what this means for your patients. If you as a center clearly transplant older patients, they live for a shorter time. You have to correct for that in the survival curves.’

Encouraging to play

‘I can get an incredible amount out of the dashboard now. I will soon be demonstrating the possibilities of the dashboard in my department. I want to encourage others to play with it themselves. So much data has become available. It takes time to discover and analyze it all. I am giving my team an initial summary of my lessons. Of course, it is also fun to establish together that we are doing things well, but also to look together at where there is potential for improvement. I want to take more time for it myself; it really is a playground.’

Don't make it too difficult for yourself

‘To colleagues in the field, I would like to say: ‘Don't make it too difficult for yourself at the beginning. Don't worry too much at first about whether data is comparable. You might get stuck. Play with the tool first. Select a time period yourself and define a few things that are relevant to your work, such as waiting time and dialysis duration. We are all intelligent enough to understand that there are social differences between Amsterdam and Rotterdam and here in Groningen. Interpreting figures exactly is essential, but that comes later.’

Including and linking even more data

‘It is my dream that all the data that is currently still scattered will be properly linked so that the entire group of kidney failure patients can be seen. In this system, you find all dialysis outcomes, including those of non-transplanted patients. That data is currently still in a separate register from Nefrovisie. Another wish of mine is that data can also be viewed regarding the acceptance and rejection of post-mortem kidneys. I would like to know what the situation is nationally and whether we are stricter or more generous than other centers.’

Very proud

‘There are always wishes left, but I don't think you should underestimate how beautiful the tool already is and the transparency we are creating with it. That the centers are now at a point where this is allowed without complaint. That we can look into each other's kitchens. That is truly amazing! I think we are also leading the way internationally with this. The NTS has really created something fantastic that they can be truly proud of. They should really promote that more.’