Mr de Blok, your care organisation Buurtzorg comes in spite of 15'000 employees with virtually no hierarchy and Management. What prompted you 15 years ago to start this company?
I am a trained nurse and have worked for a long time in this profession. Later, I worked as a Manager in home care institutions. I was always more aware of how catastrophic the impact of New Public management.

to what Extent?
Manager to control the staff with targets, the administration effort grows immeasurably, because everything is measured, controlled, optimized needs to be. The result is that the customers are not healthy and the care of the sick. I didn't want to quit by and watch as more and more nurses and nurses out of frustration with their Job. So I started Buurtzorg with the aim to create an environment in which these people, once again a good Job can make.

The changer of care

Jos de Blok (59) was a Manager in organizations of health care in the Netherlands before he established in 2006 with four nurses, Buurtzorg. He is a trained nurse and is regarded in the Netherlands as a big changer when it comes to the organization of outpatient (home) care. (red)

How did you reach this?
people who take the nursing profession, have the Band a high level of intrinsic Motivation and a high level of professional ethics. So it was to allow you in your work as much as possible of the design space and relieve you of administrative duties. Where there are too many rules and too strong power structures, relations broken, and people are cynical. Where people take on responsibility and together solutions can be found, you feel responsible and develop self-initiative.

How you have achieved this, specifically?
We rely on small Teams of a maximum of twelve Nurses who organize themselves. 97 percent of the employees in this industry are women. Many people have said to me: "We don't want to be as children. We educate children, organize a budget, bear in honorary positions of responsibility. But in the Job it was expected of us that we turn off the brain and work tasks off that are pretending to be a Manager." With us it is different. Since the Teams decide practically everything yourself: How do you organize the care of whom you hire, who works when.

And what connects the many small Teams?
We have a Central Administration with a staff of about 50 people. It makes no rules, but the goal is to relieve the Care – for example, through payroll or IT Services. We built a dedicated IT platform, so that we can share experiences. And we employ 20 Coaches, which support the caregivers in challenging situations. But one of the main objectives is to keep the back office as small as possible and not to react to any change with the new rules. In our industry there are almost daily new requirements from the state, by health insurance, of Physicians. If you are not careful, the endless internal rules. The kill Motivation.

There are certain requirements needs.
In the case of Buurtzorg is to find each Team's own solutions. This includes the right to make mistakes. Their own solutions are always better than imposed. Also, what is in Amsterdam right can be, in Limburg, completely wrong. That's why it would be a bad idea, if we were to make from the Central rules.

"We are not only in the
satisfaction of the customer at the top, but also at the costs."

And what is the role you have as chief?
As a founder, I embody our Ambition to transform the Dutch health care system. I was already as a child, is allergic to strong power structures, therefore, I relied on a form of organisation, which works also in the case of strong growth without hierarchy. My Job is to guarantee a consistently high level of quality and to ensure that there is as little as possible rigid structures and rules. And that we affect with our approach to other actors. We have not adapted to the requirements of the health insurance, but with insurers ' own contracts drawn up.

could you be more specific?
Previously, it was economically interesting, if the customer remained sick. Those who invested in the prevention, had financially none of it. This is one of the reasons why the costs are exploding in the health sector – all focused on repair. The care staff but would like to improve the quality of life of customers, not as many hours to settle. We focus so heavily on prevention and self-empowerment. And focus, as our name says, on mutual aid, networking of the various local actors, for example, in the care of people with dementia. If someone is suffering from Isolation or a lack of exercise, helped him with outpatient care alone little. Then, it is important that Volunteers do with him, walks or games in the evenings to organize. And that we train the families, as the Situation can handle.

Also, you need to earn money to raise wages, and grow paying. How do you open the bill?
We are a Non-Profit organization that has financed their growth from their own strength. I hate financial dependence, so there is no debt financing, and the Profit flows in the development. Meanwhile, other industries ask me for advice. I give Workshops in banks undSchulen and research at the University of Banasthali in India to the question of how the world of work can best be transformed.

there Is a proof that the Buurtzorg model is more successful than conventionally-organized nursing organizations?
There are now several studies that show how well our approach works. We are not only customer and employee satisfaction at the branch tip, but also at the cost. The average cost per customer and year in Holland at 6000 euros, in the case of Buurtzorg, there are 4900 euros per year and per customer. The results at 600'000 customer a saving of 660 million euros in a year.

Buurtzorg now has offshoots in the USA, Sweden, England, Japan, China and South Korea as well as Germany and Austria. When are you coming to Switzerland?
There is already a cooperation with public and private home care providers in Zurich, interested in our model. But that is not running under our name. We don't have to do that anywhere myself; it is crucial that the organizations are stronger to the benefit to the customer, and the work of Care and help reduce healthcare costs.

Created: 08.03.2020, 19:03 PM