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Richard van Veen and Harry Honebecke are technicians at the Dialysis Centre in Groningen

Excellent maintenance,
carefree health care
The dialysis machines at the Dialysis Centre in Groningen, the Netherlands, save patients’
lives every day. Maintenance of these machines is quite literally a matter of life and
death. That’s why the technical department has structured and digitized all maintenance
activities. “Of course this is very useful for management and auditors. But you really do it
for yourself and the patients: you know you won’t forget anything.”
Text: Niek Steenhuis Photography: Aad Hogendoorn

“Do you see the difference?” Harry Honebecke is holding up two When proper maintenance is a matter of
cups of water. He just filled them from two different faucets that are life and death
connected to the water treatment machine we’re standing next to. Harry Honebecke is a technician at the Groningen Dialysis Centre. He and
One cup is crystal clear, the other slightly less so. “This is the water three others share responsibility for maintaining all machines needed for
we all drink at home every day. The clear liquid is what you get when over a hundred treatments that are provided at the centre and at patients’
you thoroughly filter tap water: this is pure H2O. But pure H2O is too homes. They provide maintenance for the equipment at the Dialysis centre’s
corrosive for the human body, so after we filter the water we rarefy it main location near Groningen University Hospital – such as the water
with a controlled dose of other substances. This way, we make sure the treatment plant and over a hundred dialysis machines – as well as for the
water that’s used for dialysis is safe.” equipment at a number of health care centres throughout the region.

“The patients’ lives depend on this equipment,” says Honebecke. Support for your plan is
important, but sometimes you
“They have to get Dialysis treatment three times a week for four hours,
longer if they choose to be treated at home. These treatments are
exhausting, but patients simply can’t survive without them.” So proper
maintenance of all the equipment really is a matter of life and death,
have to take action and decide:
and it determines the quality of the treatment. The water has to be it’s time for a change right now.
just right, the machinery has to work perfectly and power outages
must be prevented at all cost.

Excel lists and hardcopy calendars Throw away the calendar
In order to keep up the maintenance, technical staff had to do a lot Two years ago, Honebecke and Van Veen started implementing TOPdesk
of administrative work before they introduced TOPdesk. “There were to keep a digital record of reactive and planned maintenance. They
a lot of lists,” says Honebecke. “We had several records of assets that were very happy with the system, but their colleagues were initially
were stored in a cabinet somewhere. And for each piece of equipment sceptical. Van Veen: “We and the TOPdesk consultant worked hard to
we had an excel sheet to keep track of maintenance.” “Besides these show them the benefits. We had to do a lot of talking and we used a test
sheets, we also used a hard copy calendar for the same purpose,” adds environment to show how it would make their work easier.”
Honebecke’s colleague Richard van Veen. The digitization process wasn’t always easy, Van Veen admits: “We
Honebecke: “Keeping track of everything at the same time was wanted to get rid of the old calendar, but people simply wouldn’t stop
a big problem. Maintenance for the most critical equipment like using it. Just after we’d decided we weren’t going to use it anymore, a
dialysis machines and water treatment was fine, but for non-critical colleague walked by and wrote an appointment down in it. It was too
equipment, finding the right information was difficult. The lists didn’t much of a habit. So one day we just threw the calendar away. We didn’t
provide a simple overview of which tasks needed to be done. You hide it or put it away somewhere safe, we actually threw it out. It’s
always had to go through all the lists to check what the status was of important to get support for your plan, but sometimes you have to take
a task and whether you needed to follow up on it. So sometimes we action and decide: it’s time for a change right now.”
ended up doing the same tasks twice.”

Easier outsourcing, onboarding and transferring
Agreements, questions and ambition The technical department has now been working with a digital system
Eventually the situation really started to affect our work. Partly because for maintenance work for over a year. Colleagues now submit incidents
management wanted more insight into the organization’s assets, such as for their equipment online and the incidents are processed digitally by the
what equipment was available, when it needed maintenance and when technical department. For preventative maintenance they plan procedures
it needed to be replaced. Besides that, legal agreements lead to stricter beforehand, and they automatically appear on the department’s to do
audits where the auditors would check whether health care organizations list at the right time. Van Veen has noticed that this digitization has led to
keep track of the life cycle of all their equipment. Organizations that can’t better insight into the department’s work. “We can see exactly what we’re
provide proof of this risk losing their certification. spending our time on. So it’s also easier to see whether we need to have
But more importantly, Honebecke and Van Veen themselves had the some work outsourced because our week is too full.”
ambition to create clear overviews to help them deliver the best work Digitization has also made it easier to transfer work to a colleague. They
they could. Van Veen provides an example: “When one of us was off sick, benefited from this almost immediately after TOPdesk was implemented.
colleagues would often call me saying that that person had promised to Van Veen: “In 2015 our team went from four to three people. Thankfully
fix something, but hadn’t done so. I’d have no idea what they were talking we’d already set up TOPdesk by then, so we had insight into the fourth
about, which wasn’t very professional of course. You don’t want to bother person’s responsibilities and could transfer them to other team members
customers with issues within your own department.” easily.” At the end of last year a new member was added to the team. “He
settled in much more quickly because all the information he needed was
already available in TOPdesk.”

A relaxed work environment
Honebecke and Van Veen often use the word “relaxed.” Honebecke:
“TOPdesk has been a great help. It makes the whole process much more
relaxed.” Van Veen: “We always have an overview of which incidents
and tasks are still open. And because all planned maintenance is
registered, you know all that work will automatically appear on your
to do list.”
“Of course things don’t always go perfectly,” Honebecke adds, “but
at least we’re aware of what goes wrong now. And it’s easier to
determine why something hasn’t been done yet.”
When things are more relaxed there’s a lot less clutter in people’s
minds and their calendars. Van Veen: “We know that the basics
are taken care of, so we can focus on other things. For instance, we
switched to a different type of dialysis machine last year. It took a lot
of work: researching the options, getting quotes, buying the machines,
the list goes on. And you have to account for each step you take. We
have a lot more time for things like that now.”

The recipe for success at this dialysis centre’s technical department:
• A
 lmost all incidents for reactive maintenance are submitted via s hould anything be shared about existing incidents, who’s doing
the self-service portal. Every time a colleague called or came to the maintenance and where?
department, technical staff kindly asked them to create an incident, • E
 very week, one team member is on call 24 hours a day. This person
so it became a habit. Now the technical staff just needs to link the can be called for emergencies and keeps an eye on incoming
incident to the right machine. incidents, so that the other three don’t have to worry about this.
• T
 he technical department has implemented yearly procedures for This person also does that week’s recurring checks.
preventative maintenance. These tasks are automatically added to • R
 ight after a team member finishes a maintenance task, they
the task list at the right time, including a description of what needs update the relevant information: they fill out paperwork and close
to be checked. Some machines needs to be checked daily, like the the incident. The entire team is responsible for this. This requires
water treatment plant, others are checked each month or year. discipline, but they worked hard at it from the start, so the system
• E
 ach morning the technical department has a short meeting to is always up-to-date.
discuss and divide tasks for the day: What incidents have come in,

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