TOPDESK MAGAZINE - MARCH 2017 23

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. Thats 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 wont forget anything.
Text: Niek Steenhuis Photography: Aad Hogendoorn

Do you see the difference? Harry Honebecke is holding up two
cups of water. He just filled them from two different faucets that are
connected to the water treatment machine were standing next to.
One cup is crystal clear, the other slightly less so. This is the water
we all drink at home every day. The clear liquid is what you get when
you thoroughly filter tap water: this is pure H2O. But pure H2O is too
corrosive for the human body, so after we filter the water we rarefy it
with a controlled dose of other substances. This way, we make sure the
water thats used for dialysis is safe.
When proper maintenance is a matter of
life and death
Harry Honebecke is a technician at the Groningen Dialysis Centre. He and
three others share responsibility for maintaining all machines needed for
over a hundred treatments that are provided at the centre and at patients
homes. They provide maintenance for the equipment at the Dialysis centres
main location near Groningen University Hospital such as the water
treatment plant and over a hundred dialysis machines as well as for the
equipment at a number of health care centres throughout the region.
24 TOPDESK MAGAZINE - MARCH 2017
The patients lives depend on this equipment, says Honebecke.
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 cant survive without them. So proper
maintenance of all the equipment really is a matter of life and death,
and it determines the quality of the treatment. The water has to be
just right, the machinery has to work perfectly and power outages
must be prevented at all cost.
Excel lists and hardcopy calendars
In order to keep up the maintenance, technical staff had to do a lot
of administrative work before they introduced TOPdesk. There were
a lot of lists, says Honebecke. We had several records of assets that
were stored in a cabinet somewhere. And for each piece of equipment
we had an excel sheet to keep track of maintenance. Besides these
sheets, we also used a hard copy calendar for the same purpose, adds
Honebeckes colleague Richard van Veen.
Honebecke: Keeping track of everything at the same time was
a big problem. Maintenance for the most critical equipment like
dialysis machines and water treatment was fine, but for non-critical
equipment, finding the right information was difficult. The lists didnt
provide a simple overview of which tasks needed to be done. You
always had to go through all the lists to check what the status was of
a task and whether you needed to follow up on it. So sometimes we
ended up doing the same tasks twice.
Agreements, questions and ambition
Eventually the situation really started to affect our work. Partly because
management wanted more insight into the organizations assets, such as
what equipment was available, when it needed maintenance and when
it needed to be replaced. Besides that, legal agreements lead to stricter
audits where the auditors would check whether health care organizations
keep track of the life cycle of all their equipment. Organizations that cant
provide proof of this risk losing their certification.
But more importantly, Honebecke and Van Veen themselves had the
ambition to create clear overviews to help them deliver the best work
they could. Van Veen provides an example: When one of us was off sick,
colleagues would often call me saying that that person had promised to
fix something, but hadnt done so. Id have no idea what they were talking
about, which wasnt very professional of course. You dont want to bother
customers with issues within your own department.
Support for your plan is
important, but sometimes you
have to take action and decide:
its time for a change right now.
Throw away the calendar
Two years ago, Honebecke and Van Veen started implementing TOPdesk
to keep a digital record of reactive and planned maintenance. They
were very happy with the system, but their colleagues were initially
sceptical. Van Veen: We and the TOPdesk consultant worked hard to
show them the benefits. We had to do a lot of talking and we used a test
environment to show how it would make their work easier.
The digitization process wasnt always easy, Van Veen admits: We
wanted to get rid of the old calendar, but people simply wouldnt stop
using it. Just after wed decided we werent going to use it anymore, a
colleague walked by and wrote an appointment down in it. It was too
much of a habit. So one day we just threw the calendar away. We didnt
hide it or put it away somewhere safe, we actually threw it out. Its
important to get support for your plan, but sometimes you have to take
action and decide: its time for a change right now.
Easier outsourcing, onboarding and transferring
The technical department has now been working with a digital system
for maintenance work for over a year. Colleagues now submit incidents
for their equipment online and the incidents are processed digitally by the
technical department. For preventative maintenance they plan procedures
beforehand, and they automatically appear on the departments to do
list at the right time. Van Veen has noticed that this digitization has led to
better insight into the departments work. We can see exactly what were
spending our time on. So its also easier to see whether we need to have
some work outsourced because our week is too full.
Digitization has also made it easier to transfer work to a colleague. They
benefited from this almost immediately after TOPdesk was implemented.
Van Veen: In 2015 our team went from four to three people. Thankfully
wed already set up TOPdesk by then, so we had insight into the fourth
persons responsibilities and could transfer them to other team members
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.
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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 dont always go perfectly, Honebecke adds, but
at least were aware of what goes wrong now. And its easier to
determine why something hasnt been done yet.
When things are more relaxed theres a lot less clutter in peoples
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 centres technical department:

A
 lmost all incidents for reactive maintenance are submitted via
the self-service portal. Every time a colleague called or came to the
department, technical staff kindly asked them to create an incident,
so it became a habit. Now the technical staff just needs to link the
incident to the right machine.
T
 he technical department has implemented yearly procedures for
preventative maintenance. These tasks are automatically added to
the task list at the right time, including a description of what needs
to be checked. Some machines needs to be checked daily, like the
water treatment plant, others are checked each month or year.
E
 ach morning the technical department has a short meeting to
discuss and divide tasks for the day: What incidents have come in,
s hould anything be shared about existing incidents, whos doing
maintenance and where?
E
 very week, one team member is on call 24 hours a day. This person
can be called for emergencies and keeps an eye on incoming
incidents, so that the other three dont have to worry about this.
This person also does that weeks recurring checks.
R
 ight after a team member finishes a maintenance task, they
update the relevant information: they fill out paperwork and close
the incident. The entire team is responsible for this. This requires
discipline, but they worked hard at it from the start, so the system
is always up-to-date.