Since the 1980s many countries have developed complex ways of working to protocols. Governance and compliance systems increased rather than reduced bureaucracy and led to a focus on control. When I started Buurtzorg in 2006 I wanted to break through the existing systems which were the result of years of public management. I used my own experience as a community health nurse to show that a system built on trusting professional workers creates much better outcomes.
My vision is simple. When you are educated to work with families and children you are intrinsically motivated to do the right things. You find solutions for the problems you face and build a network of people who can contribute when needed. When you have collegial relationships without hierarchy everybody feels responsible and everybody experiences ownership. The daily routine is the key element of the work and every day is an opportunity to learn and develop. Interventions need, of course, to be professional and based on professional standards. Professional workers should be allowed to report the effectiveness of their work based on the professional interventions and their quality criteria.
For Buurtzorg we have chosen the Omaha system which shows data on ‘problems, interventions and outcomes’. With the support of good IT, bureaucracy can be minimized while remaining meaningful enabling us to continually learn from what we are doing.
When we build organisations from the perspective of citizens, families with problems, vulnerable children and from the perspective of professional youth care workers, they will be simple and organic.
When we start to build from the perspective of systems, of rules and regulations we create complex organisations with lots of bureaucracy.
Let’s choose humanity above bureaucracy!
Jos de Blok
Jos de Blok is the founder and CEO of Buurtzorg (neighbourhood nursing), a Dutch organisation with more than 10 000 employees, offering community based (home) care services to more than 70 000 patients a year. Founded in 2006 with one team of four nurses, Buurtzorg has transformed home-based health care by creating an innovative approach to the provision of nursing care at home.
Jos de Blok is the keynote speaker at the online event on self-managing organisations 9th September 2020, organised by Itla Children’s Foundation and Varma.