Buurtzord Nederlands is a nonprofit home-care company that started with a handful of employees in 2007 and grew in a little under a decade to about 8,000 nurses delivering care for 65,000 patients. The phenomenal growth of this Dutch company has been attributed to its radically different approach to delivering home care through self-managed teams, which provide high-quality care at lower cost than competitors. In the Netherlands, home-care companies contract with government-funded insurance firms to provide services to patients needing home care. These services include temporary care following hospitalization or an end-of-life decision and long-term care for those suffering chronic conditions or dementia. In this industry, nurses typically deliver only those services requiring their expertise while less skilled and less costly employees perform daily-living tasks such as, dressing and bathing. These various care givers provide services on different days and at different times, making it difficult to coordinate patient care and leading to both patient and nurse dissatisfaction. Buurtzorg's self-managed team approach tackles this continuity-of-care problem while providing a high level of patient care. It was the brainchild of CEO and cofounder Jos de Blok, whose extensive nursing experience and strong humanistic values inspired a compelling vision of how home health care should be delivered and what it should do. He envisioned a holistic, neighborhood approach to home care where teams of professional nurses create and coordinate networks of care providers and resources to meet patient needs. The goal is to maximize patients' independence and self-care as evidenced by de Blok's favorite motto: "humanity over bureaucracy." Buurtzorg's teams of 10-12 highly-skilled nurses are responsible for providing the entire range of care services to 50 to 60 patients in a neighborhood. The teams coordinate with patient families, primary care givers, and community resources to serve patients and to help them attain as much of an independent life style as possible. Sophisticated information technology integrates data about patient care and health, scheduling, and billing to facilitate a continuous care process where teams share information, serve patients' needs in real time, and identify and address problems rapidly. Teams do not report directly to managers but have the autonomy and flexibility to adjust work arrangements and schedules and to make relevant and timely decisions as circumstances demand. Buurtzorg's 700 self-managed teams are supported by 15 coaches who help solve problems when needed, usually on issues related to team functioning and development. A small back office performs administrative functions for teams. The firm's surplus revenues fund continuing nurse training and team projects and organizational innovations to improve community health and the organization itself. Buurtzorg's self-managed team approach performs exceptionally well on stan.

1. Buurtzord Nederlands is a nonprofit home-care company that started with a handful of
employees in 2007 and grew in a little under a decade to about 8,000 nurses delivering care for
65,000 patients. The phenomenal growth of this Dutch company has been attributed to its
radically different approach to delivering home care through self-managed teams, which provide
high-quality care at lower cost than competitors.
In the Netherlands, home-care companies contract with government-funded insurance firms to
provide services to patients needing home care. These services include temporary care following
hospitalization or an end-of-life decision and long-term care for those suffering chronic
conditions or dementia. In this industry, nurses typically deliver only those services requiring
their expertise while less skilled and less costly employees perform daily-living tasks such as,
dressing and bathing. These various care givers provide services on different days and at
different times, making it difficult to coordinate patient care and leading to both patient and
nurse dissatisfaction.
Buurtzorg's self-managed team approach tackles this continuity-of-care problem while providing
a high level of patient care. It was the brainchild of CEO and cofounder Jos de Blok, whose
extensive nursing experience and strong humanistic values inspired a compelling vision of how
home health care should be delivered and what it should do. He envisioned a holistic,
neighborhood approach to home care where teams of professional nurses create and coordinate
networks of care providers and resources to meet patient needs. The goal is to maximize patients'
independence and self-care as evidenced by de Blok's favorite motto: "humanity over
bureaucracy."
Buurtzorg's teams of 10-12 highly-skilled nurses are responsible for providing the entire range of
care services to 50 to 60 patients in a neighborhood. The teams coordinate with patient families,
primary care givers, and community resources to serve patients and to help them attain as much
of an independent life style as possible. Sophisticated information technology integrates data
about patient care and health, scheduling, and billing to facilitate a continuous care process
where teams share information, serve patients' needs in real time, and identify and address
problems rapidly. Teams do not report directly to managers but have the autonomy and
flexibility to adjust work arrangements and schedules and to make relevant and timely decisions
as circumstances demand.
Buurtzorg's 700 self-managed teams are supported by 15 coaches who help solve problems when
needed, usually on issues related to team functioning and development. A small back office
performs administrative functions for teams. The firm's surplus revenues fund continuing nurse
training and team projects and organizational innovations to improve community health and the
organization itself.
Buurtzorg's self-managed team approach performs exceptionally well on standard measures of
home health care. Patient satisfaction, care, and health ratings place the firm among the best in
the country, while its service and overhead costs are significantly below those of other Dutch
home-care companies. High patient and family satisfaction scores and good health results
promote referrals from physicians, hospitals, and many others. Moreover, the team model is

2. popular among Dutch nurses in this industry, facilitating recruitment and retention of skilled
staff.
Buurtzorg's highly successful team model of home health care has received considerable
notoriety worldwide, helped by de Blok's decidedly visible and effective advocacy. Efforts to
apply self-managed teams to home care are progressing in Japan, Norway, Sweden, the United
Kingdom, and the United States. As might be expected, the team model has received some
criticism particularly from Dutch competitors who argue that Buurtzorg selects patients to
maximize billable hours, revenue, and unplanned care provided by others Consequently, the
Dutch Ministry of Health, Welfare, and Sport hired KPMG to study these allegations and to
compare Buurtzorg's performance with that of competitors. KPMG found little support for these
assertions. Going forward, the Dutch home care industry is likely to become more competitive
and to face growing government pressures for cost containment. This will test the long-term
sustainability of Buurtzorg's self-managed team approach to home health care.
Which of the following factors played a role in Buurtzord's decision to implement self-managed
teams?
a. The CEO's values
b. Coordination among home health care tasks
c. Flexibility to meet patients' changing needs
d. All of these are correct.