Jos de Blok is CEO of Buurtzorg, a non-profit healthcare foundation based in the Netherlands with 14,000 employees. He experienced a Level 4 way of working in self-organised teams as a nurse in the 1980s. But he later moved to larger, more hierarchical organisations. While these appeared to be better organised, the quality of care declined and costs increased. So in 2006, together with a group of friends, he sought to create a low-hierarchy, team-based way of working with a local focus. (‘Buurt’ means neighbourhood in Dutch.)
De Blok started with just one team, but within a few years the organisation employed more than 2,000 nurses. “The nurses organised their own week,” he says.
“They had a good relationship with the GPs so they got referrals from them. They liked the fact that by organising the work themselves they felt more responsible. It felt like they were free again.
“So we are free to work according to our professional ethics, we don’t have to follow orders from a strictly-organised management and we can focus on the patient.”
While some back office functions have been introduced, the administration has been kept as light and the number of rules as few as possible.
Growth has been spectacular. Turnover rose from €1 million in 2007 to €12 million in 2008.
“With a different management approach we would never have achieved what we have now,” says de Blok, who calculated that his organisation’s costs are 20% lower than the average.
This provides huge savings for the government when it uses Buurtzorg, which delivers a better standard of care for patients and more job satisfaction for nurses themselves.
More details on this case study can be found in Hlupic's new book Humane Capital: How to Create a Management Shift to Transform Performance and Profit