Buurtzorg

In 2006, Jos de Blok, a nurse by training, and three colleagues founded Buurtzorg in the small Dutch city of Almelo.1 The word buurtzorg is Dutch for "neighborhood care." De Blok had spent years working in traditional home-care organizations and had grown frustrated with a system that fragmented nursing into discrete, timed tasks assigned by managers who had never met the patients.

The founding team started with one team of four nurses. They proposed a simple alternative. Self-managing teams of ten to twelve nurses would take responsibility for all care within a small, well-defined neighborhood. There would be no managers, no planning departments, and no call centers.2

The organization grew rapidly. By 2018, Buurtzorg employed more than 14,000 nurses and care workers, organized into roughly 1,000 self-managing teams, supported by fewer than 50 back-office staff, 18 coaches, and zero managers.3 More than half of all district nurses in the Netherlands worked for the organization.4

An Ernst & Young audit documented savings of roughly 40 percent to the Dutch healthcare system, because nurses who managed their own patient relationships could provide more effective care in fewer hours.5 A KPMG study confirmed that Buurtzorg was a low-cost home-care provider whose savings were not attributable to patient mix.5

Buurtzorg was named Best Employer in the Netherlands five times between 2010 and 2016.4 Coaches, who served 40 to 50 teams each, had no decision-making authority. Their role was to ask questions that helped teams find their own solutions. Jos de Blok limited his meetings with coaches to quarterly, deliberately avoiding the creation of an executive management committee.6

The model has been adopted or piloted in more than 25 countries, including Sweden, Japan, the United States, the United Kingdom, China, and South Korea.3 In Wales, the National Health Service launched a two-year Buurtzorg pilot in 2018.4 De Blok received the Albert Medal of the Royal Society of Arts in 2014.3