Buurtzorg: humanity above bureaucracy by integrating simplification in a teal organization
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Buurtzorg is a Dutch community care organization founded in 2007, which emphasizes independent teams of nurses providing comprehensive care without bureaucracy. By leveraging autonomy and reducing complexity, it has grown to 10,000 nurses in 850 teams, focusing on high-quality, patient-centered care, leading to high satisfaction rates among clients and employees. The organization operates with low overhead costs and promotes innovation in various care sectors, influencing healthcare models nationally and internationally.
Buurtzorg: humanity above bureaucracy by integrating simplification in a teal organization
- 1. Jos de Blok Buurtzorg: humanity above bureaucracy by integrating simplification in a teal organization
- 2. Buurtzorg – Quick Scan • New organization and care delivery model • Started in 2007 with 1 team/4 nurses • Community Health Care instead of homecare • 2016: 10.000 nurses in 850 ‘independent’ teams. • 4000 careworkers at Buurtdiensten/Familiehulp • 45 staff at the back office and 19 coaches • 70.000 patients a year • 360 million
- 3. Results dutch policy on homecare 2006 • Fragmentation of cure, care, prevention • Standardization of care-activities/tasks • Lower quality / higher costs: wrong incentives: delivering much care against low cost is profitable • Big capacity problems due to demographic developments • Clients confronted with many caregivers • Information on costs per client/outcomes: none!
- 4. Start Buurtzorg 2007 Starting an organization and care delivery model for community care with: – independent teams of max 12 nurses – Working in a neighborhood of 5000-10.000 p. – who organize and are responsible for the complete process: • clients, nurses, planning, education and finance; • and all kind off coordination activities!!!! • Integrating nursing/medical and social care
- 5. CLIËNT 4. Formal networks 2. Informal networks 3. Buurtzorgteam 1. Selfmanagement client Onionmodel Buurtzorg Buurtzorg works inside-out: empowering and adaptive, networkcreating, supporting. Vision: support indepence!
- 6. (Self)-Organisation • Optimal autonomy and no hierarchy: TRUST • Complexity reduction (also with the use of ICT) • Max of 12 nurses a team, 40 à 50 clients • Generalists: taking care for all type of patients • 70% registered nurses/30% nurse assistents • Their own education budget • Informal networks are much more important than formal organizational structures • Training SIM: selfsteering and coaching
- 9. Different types of clients • Chronically ill and functionally disabled clients • Elderly clients with multiple pathology • Clients in a terminal phase • Clients with symptoms of dementia • Clients who are released from the hospital and are not yet fully recovered
- 10. Quality system • Monitoring outcome instead of production: the Omaha system • Roles and activities • Teamcompass • High education level: 70% is RN (average 20%) • And of course: clientsatisfaction!
- 11. Supporting the independent teams • 45 people in 1 back office; 19 coaches, managers 0! 2 directors. • Taking care of inevitable bureaucracy, so the nurses won’t be bothered with it! – The care is charged. – The employees are paid – Making financial statements
- 12. ICT makes it possible! - Buurtzorgweb Grip on the business Position in the care-chain, relationship whit other caregivers. View on quality of care, transparency Shared values Community Instruments Communitation in the care chain Production Relationship professional and client
- 13. Buurtzorgweb – some aspects • Community • Clients and employees data • Hour registration. • Sharing documents • All the necessary administration for accountability to cost providers, inspection etc. • Planning
- 14. Community • Shared values. Nurses work all over the country but feel like ‘one’ • Nurses can ask for good examples from colleagues all over the country. • Man. Dir. can easily check the ideas of the teams • The back office has an easy way of communication with all the nurses • Contact between nurses and informal care and other caregivers from the neighborhood
- 15. What we don’t do • Management meetings • Policy notes • Strategic documents • HR strategies • Year plans • and other useless things
- 16. Buurtzorg is Dutch most fast growing organization Started in 2007 2016: 10.000 nurses in 850 teams
- 17. Buurtzorg in the whole country
- 18. New innovations • Youth care • Domestic/social care • Mental care • Pensions: rehabilitation • Hospices • Physiotherapy/OT
- 19. international • Sweden • USA • Asia: China, Korea, Japan…...... • Czech Republic • UK • Etc
- 20. New theoretical model? Frederic Laloux: reinventing organizations: • Selfmanagement • Wholeness • Evolutionairy purpose Sharda Nandram: Integrating simplification • Needing principle • Rethinking principle • Common sense principle
- 22. Satisfied employees • Thousands of nurses quit their job at traditional organization and went to work for Buurtzorg • They appreciate: – Working in small teams – Working autonomous – Independency – Strong teamspirit – User-friendly ICT • Price for best employer 2011/2012/2014/2015
- 24. Satisfied clients • Good quality of care. • "Compaired to 307 other organizations for community care they give the highest score to Buurtzorg. (NIVEL 2009)“ • Highest clientsatisfaction rates: 9,1 • Supported by patient- and elderly organizations • Less admissions in hospitals and nursinghomes
- 25. Radio Steunkous
- 27. Cost effectiveness for the organization • Overhead costs: 8% (average 25%) more money for the care, innovation and education • Surplus: 4% (non profit)
- 28. Cost Benefits for the Care! • The home care would be 65% of the costs (Buurtzorgs model leads to more prevention, a shorter period of care and less spending on overhead) • More satisfied employees and clients • The government an all political parties are stimulating other care organization to work like Buurtzorg. • Other sectors are interested in the organization model
- 30. Thank you for your attention