Introduction
I love reading about different management methods in the business world. Reinventing Organizations explores how organizations can adopt practices that are more suitable for our time, promoting autonomy, shared responsibility, and collaboration to create more fulfilling and high-performing work environments.
Buurtzorg: Home Care
Buurtzorg is a home care organization founded in 2006 by Jos de Blok, a former nurse himself. The main goal of Buurtzorg is to provide quality and patient-centered care while offering a fulfilling work environment for caregivers.
What sets Buurtzorg apart from traditional healthcare models is its organizational approach. Instead of having a traditional hierarchical structure with managers and supervisors, Buurtzorg is organized in a self-managed way. The home care teams consist of around 10 to 12 caregivers who work in a self-organized manner and make decisions collectively (yes, it sounds like Scrum).
Why Buurtzorg Was Created?
Several reasons!
Loss of Meaning: Loss of Quality
The traditional healthcare system often focused on productivity and the number of patients to be treated, neglecting the quality of care and the trust relationship with patients. Excessive bureaucracy, lack of autonomy, and a lack of understanding of the reality on the ground by supervisors greatly limited the possibilities for the staff.
Being restricted to a maximum of 5 minutes of care with a patient because there is “just an injection,” is that really medical care? High costs, inefficiency in the delivery of care, and a loss of meaning for medical staff contributed to the realization that led to the creation of Buurtzorg.
Returning to the “Why?”
Compassion, Integrity, Altruism, these are some values that come to mind when I think of caregivers, and maybe other words come to your mind.
We can ask ourselves: Why do we take care of people? And what does it mean to not do it with care? Does it have consequences to time our interventions down to the second? And if a person is poorly cared for, what happens? And if our desire to do things quickly makes us overlook an important detail?
It is important to consider that in the medical field, an error or negligence is much more serious than in IT: a poorly cared for person is a person who, in the worst case, risks death. From a more “pragmatic finance” perspective, for the healthcare system, a person going to the hospital means additional expenses that could potentially be avoided.
Instead of focusing solely on tasks and productivity measures, Buurtzorg encourages its teams to reconnect with the reason they chose to work in the medical field. The company recognizes the importance of giving meaning back to the work of caregivers by emphasizing personal development, the quality of care, and patient satisfaction. There is a desire to regain a sense of motivation, satisfaction, and connection with their work.
The Change
Buurtzorg introduced a revolutionary self-organization model in the healthcare sector. Bureaucracy and any notion of “boss” are eliminated. At the heart of this model is the autonomy given to home care teams. Buurtzorg caregivers have the freedom to make decisions and plan care based on the individual needs of patients. This autonomy promotes better personalized care, better support, and a relationship of trust built between healthcare professionals and patients.
The Buurtzorg culture allows for:
- A relationship between the patient and their healthcare professionals: listening to concerns and needs, involving patients in their care journey.
- Personalized care: a willingness to meet the needs of each individual, recognizing that each patient is unique, both medically and as a human being, with different preferences, values, or goals.
- Coordination of care: working closely with other healthcare professionals.
- Support for families: providing guidance, advice, and education on patient health issues.
Furthermore, Buurtzorg emphasizes a holistic approach to care. The results achieved by Buurtzorg are impressive, as the company has improved the quality of care while reducing costs.
Success
- Buurtzorg is ranked #1 in customer satisfaction studies among more than 300 care organizations.
- In 2010, a study conducted by KPMG revealed that Buurtzorg resulted in a 40% reduction in care and support expenses per person supported, resulting in savings of hundreds of millions of euros for the Dutch social security system.
- Another KPMG study in 2015 demonstrated that Jos de Blok’s service saved an average of 3,000 euros per patient for home hospitalization in the Netherlands.
- For the same level of service to patients, the number of hours required by Buurtzorg is 35% lower compared to Dutch competitors.
- In the Netherlands, emergency admissions have reduced by 30%.
- Despite a smaller presence, Buurtzorg has a higher satisfaction index (evaluated by patients) compared to its competitors.
What’s Next?
Buurtzorg continues to develop its vision for healthcare worldwide.
They share their knowledge, experience, and best practices with others interested in adopting a similar approach in their own contexts. Buurtzorg has organized training programs and workshops to help healthcare professionals understand the fundamental principles of the model and learn how to effectively implement it.
They have also provided support in terms of advice and practical guidance to help new enterprises navigate the challenges and opportunities associated with adopting the Buurtzorg model. This includes guidance on governance, human resource management, care coordination, and establishing an organizational culture based on autonomy and accountability.
My IT Parallel (a bold one)
How often is quality deliberately set aside in favor of “delivering quickly”?
How does this culture of misplaced value affect us?
Do we trust the work we produce? Do we find meaning in it?
And when a feature has a bug, it is the maintenance team that takes care of it… Sometimes, we hear: “It’s not a problem, now it’s another project manager who handles that part! It’s a different budget. It’s not our objective anymore…” Yet, the objectives of companies are supposed to serve the same cause, right? And this overall waste, how much does it cost if we go beyond the notion of a budget per department?
Could we have avoided this new expense and the associated frustration for both clients and technicians? Yes, in a sense, I compare a patient going to the hospital due to negligence with a Redmine/Jira ticket regarding a functional bug: Team 1 rushing to finish at the expense of objectives, estimates, and the “deadline,” and Team 2 picking up the pieces and “fixing” as best they can…
In both cases, with committed professionals and a supporting system, with objectives often counterproductive for all, the common result is significant human and financial waste.
Conclusion
Here is a great example of a different organization, and I remain convinced that we should keep an open mind to draw inspiration from successes that help change the world of work and the world as a whole.
The agile mindset and Buurtzorg share several common points. Both approaches are characterized by a flat organizational structure and increased autonomy for teams. They emphasize collaboration, shared responsibility, and decentralized decision-making. Agile teams and Buurtzorg teams both have the freedom to experiment, quickly adapt to changes, and flexibly respond to customer needs. By adopting these principles, they foster a culture of trust, accountability, and innovation within the organization.
Source: Reinventing Organizations by Frédéric Laloux