EU Models of Care webinar introducing Buurtzorg 17
EU Models of Care webinar – introducing Buurtzorg 17 September 2015
NHS European Office • Who are we? – Established 2007 – Part of the NHS Confederation – Funded by national NHS bodies • What do we do? – – Represent NHS organisations in EU policy-making and legislation Assist the NHS with the implementation of EU law Offer strategic advice on EU funding opportunities Promote partnerships between NHS organisations and bodies from other sectors/countries www. nhsconfed. org/europe
EU Models of Care • Working with NHS England to support Pioneers and Vanguards to develop links and share learning with organisations at leading edge of integrated care in Europe • An in-depth look at four different EU Models of Care throughout 2015 -16: • • Spain (Alzira) Netherlands (Buurtzorg) Sweden (Jonkoping) Germany (Gesundes Kinzigtal) • Webinar, followed by study visit – look out for the registration links • EU Models of Care conference in spring 2016 • Other events and activities throughout the year
• Integrated Care Model Pillars
Understanding the Buurtzorg model Jos de Blok Director Buurtzorg
Jos de Blok Buurtzorg: community based integrated care in a teal organization.
Buurtzorg – Quick Scan • • • New organization and care delivery model Started in 2007 with 1 team/4 nurses Delivering Community Care/working together GP’s 2015: 9500 nurses in 800 ‘independent’ teams. 45 staff at the back office and 15 coaches 70. 000 patients a year
Results policy on homecare 2006 • Fragmentation of cure, care, prevention • Standardization of care-activities • Lower quality / higher costs: wrong incentives: delivering much care against low cost is profitable • Big capacity problems due to demographic developments (shortage of 400. 000 nurses within 10 years) • Clients confronted with many care givers • Information on costs per client/outcomes: none!
Start Buurtzorg 2007 Starting an organization and care delivery model for community care with: – independent teams of max 12 nurses – Working in a neighborhood of 5000 -10. 000 p. – who organize and are responsible for the complete process: • clients, nurses, planning, education and finance; • and all kind off coordination activities!!!! • Integrating nursing/medical and social care
Vision: support indepence! 4. Formal networks 3. Buurtzorgteam 2. Informal networks CLIËNT 1. Selfmanagement client Onionmodel Buurtzorg works inside-out: empowering and adaptive, network creating, supporting.
(Self)-Organisation • • Optimal autonomy and no hierarchy: TRUST Complexity reduction (also with the use of ICT) Max of 12 nurses a team, 40 à 50 clients Generalists: taking care for all type of patients 70% registered nurses/40% bachelor degree Their own education budget Informal networks are much more important than formal organizational structures • Training SIM: selfsteering and coaching
Different types of clients • • • Chronically ill and functionally disabled clients Elderly clients with multiple pathology Clients in a terminal phase Clients with symptoms of dementia Clients who are released from the hospital and are not yet fully recovered
Quality system • Monitoring outcome instead of production: the Omaha system • Roles and activities instead of processes (DK) • High education level: 70% is RN (average 10%) • And of course: client satisfaction!
Supporting the independent teams • 45 people in 1 back office; 15 coaches, managers 0! • Taking care of inevitable bureaucracy, so the nurses won’t be bothered with it! – The care is charged. – The employees are paid – Making financial statements
ICT makes it possible! - Buurtzorgweb Shared values View on quality of care, transparency Position in the care-chain, relationship with other care givers. Community Instruments Communitation in the care chain Production Grip on the business Relationship professional and client
Buurtzorgweb – some aspects • • • Community Clients and employees data Hour registration. Sharing documents All the necessary administration for accountability to cost providers, inspection etc. • Planning
Community • Shared values. Nurses work all over the country but feel like ‘one’ • Nurses can ask for good examples from colleagues all over the country. • Man. Dir. can easily check the ideas of the teams • The back office has an easy way of communication with all the nurses • Contact between nurses and informal care and other caregivers from the neighborhood
Buurtzorg is Dutch most fast growing organization Started in 2007 2015: 8000 nurses in 800 teams
Buurtzorg in the whole country
New theoretical model? Frederic Laloux: reinventing organizations: • Self-management • Wholeness • Evolutionary purpose Sharda Nandram: Integrating simplification • Needing principle • Rethinking principle • Common sense principle
Satisfied employees • Thousands of nurses quit their job at traditional organization and went to work for Buurtzorg • They appreciate: – Working in small teams – Working autonomously – Independency – Strong team spirit – User-friendly ICT • Price for best employer 2011/2012/2014/2015?
Satisfied clients • Good quality of care. • “Compared to 307 other organizations for community care they give the highest score to Buurtzorg. (NIVEL 2009)“ • Highest client satisfaction rates: 9, 1 • Supported by patient- and elderly organizations • Less admissions in hospitals and nursing homes
Radio Steunkous
Rollatorrace http: //www. yout ube. com/watch? v=Q-f. PDr. N 5 p. BU
Cost effectiveness for the organization • Overhead costs: 8% (average 25%) more money for the care and innovation • Profit rate: 4% • Sickness rate: 4% (average 6%)
Cost Benefits for the Care! • The home care would be 65% of the costs (Buurtzorgs model leads to more prevention, a shorter period of care and less spending on overhead) • More satisfied employees and clients • The government an all political parties are stimulating other care organization to work like Buurtzorg. • Other sectors are interested in the organization model
Is England ready for a transition? • • • There are persistent problems in health care: - quality: fragmentation - demographic and costs: exploding? - human capital: frustrated professionals Problems can’t be solved with current solutions Public world is coordinating Buurtzorg activities in UK together with Resolis (Scotland)
Thank you for your attention
Understanding the Buurtzorg model Any questions?
Next Steps • We will: • Share the recording • Organise a study visit to the Netherlands soon • Follow up with colleagues interested in developing direct links with Buurtzorg– please talk to your account management team to incorporate into your support planning • Share webinar evaluation survey – please do complete! https: //www. surveymonkey. com/r/YMR 3 GX 8 • Next EU Models of Care examples: • Jonkoping webinar – 19 October at 12. 30 UK time https: //attendee. gotowebinar. com/register/3395771662321356545 • Gesundes Kinzigtal webinar – 26 November at 11. 30 UK time For more information, please contact: england. integrationpioneers@nhs. net or kate. ling@nhsconfed. org
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