Jos de Blok

2 december 2010

Buurtzorg and professionalism

History Community Care• Till 1990 community nurses: 1 fte each 3000

inhabitants• 1993: assesment – RIO – CIZ• 1990 – 2000: homehelp – community care –

homecare• 2000 – 2009:

– Delegation– Market– More than 2500 homecare companies

Results 2009

• Fragmentation of cure, care, prevention• Standardisation of care-activities• Lower quality / higher costs• 70 / 80% homecare companies financial

problems• Clients? Got lost in the system

Coördination problem

• Difficult to built substainable coördination strategies

• K model versus B model; different visions on cost control government

• AWBZ/WMO is production driven• So: nobody is responsible for coördination

unless it’s payed for

Start

Starting an organization and care delivery

model with independent teams of max 12 nurses who organize and are responsible for the complete process: clients, nurses, planning, education and finance; and… all kind off coördination activities!!!!

Motivation

• Dissatisfaction at work because of lack of autonomy and professionalism

• Excess of bureaucracy, more rules than taking care for patients

• Aiming at an organization model in which theory and practice are equally important while focussing on both individuals and the community

Guiding principles

• People want to be able to control their own lives as long als possible

• People want to keep up improve the quality of their live

• People want social participation in their own town

• People want warm relationships

Different types of patients

• Chronically ill and functionally disabled patients

• Elderly patients with multiple pathology• Patients in a terminal phase• Patients with symptoms of dementia• Patients who are released from the hospital

and are nog yet fully recovered

Results for patients

• Patients find the ‘Buurtzorg’ nurses very professional and easy accessible (24h a day!)

• The experience high quality of care. Compaired to 307 other organizations for community care they give the highest score to Buurtzorg (Nivel 2009)

Results for community nurses

• Increasing professional autonomy

• Increasing expertise

• Decreasing helplessness

Current situation

The concept of Buurtzorg is snowballing in The Netherlands. It started with 1 center in January 2007 and has presently about 265 centers in the whole country, delivering care for 30.000 patients a year

Health 2.0.

Health 2.0

Buurtzorg december 2010

• 265 centers

• 2700 nurses

• 30.000 clients a year

• 80 million euro turnover a year

Conclusion

A strong position of professionals leads to:• Respect: moral will and moral skills• Choice and empowerment• Patient involvement in health policy• Acces and support• Trustfull society