Rise of the Dutch Model of Neighbourhood Care

Adrian Schauer Posted on May 11, 2018

Almelo is a town of about 72,000 residents that sits in eastern Holland. It is there, around the middle of last decade, where a local nurse named Jos de Blok decided to do something about the growing frustration that he and other colleagues felt about having less time for actual patient care.

In a direct move away from a health system lodged in bureaucracy, de Blok devised a new system where nurses merged together to form small, self-managing teams. What started as four nurses grew to 12 per squad, responsible for 40-60 people in one geographic area. The idea caught fire in the Netherlands, where 850 teams of 10,000 nurses are spread across the country, in what has become known as Buurtzorg or, the “Dutch model of neighbourhood care.” 

While Buurtzorg was intended as a way to compete with more traditional home care organizations (and the administration that comes with them), this model of community care is now filtering into home care agencies around the world. 

Client-focused care

Buurtzorg is being either implemented or trialled in two dozen countries, including the United States, Canada, United Kingdom, Sweden, Germany, Austria, China, Japan, South Korea and Australia. 

There is good reason for this growing movement. Buurtzorg places an emphasis on care that is personal, unrushed and considerate of each client’s individual needs. This patient-focused approach can strengthen the relationship between nurse and client, and indeed home care agency and client, which results in increased engagement and ultimately, greater client satisfaction.

These self-organizing teams of nurses provide a full suite of services and care for their patients, many of whom are older adults and those with great limitations. Nurses are the key in determining the best approach to care for each person, which then rolls out in consultation with each family, the client’s family doctor, and other involved care members. With minimal oversight, nurses rely on technology to keep the operation running smoothly.

In fact, at least 60% of their time on the job is in direct client care -- completing clinical tasks, chatting with clients as you would a friend, checking on medication adherence, making sure the area is free of obstacles that pose a risk for falls, bathing and dressing clients if needed, and even tidying up around the home, ensuring the fridge contains healthy food, and even feeding a pet.  The right technology is imperative to keep things streamlined, with everything from paperless reporting, to managing schedules, to keeping track of client preferences and more.

The ultimate idea in the Dutch model of neighbourhood care is that these nurses are like clinically-skilled neighbours. They help with everything, which makes clients able to live independently with a greater quality of life.

Benefits

Yes, Buurtzorg seems to usher in higher rates of satisfaction to clients. Yes, it allows greater freedom and autonomy for nurses, which keeps the morale high. Yet this model of care is also poised to help the bottom line too. 

If you read up on Buurtzorg you’ll see a couple of reports mentioned consistently. They are:

  • A 2010 Ernst & Young study that calculated this model can save costs per patient by up to 40% as compared to regular home care agencies. 
  • A 2014 KPMG study concluded that using one nurse to provide all care proved to be more expensive if you looked at a per-hour situation. But, it found that only half the number of hours of care ended up being required. And that quality of care and patient satisfaction were up.

Ultimately, the cost savings are realized because patients tend to stay in a home environment, and not take up hospital beds, seats in the emergency department, or rooms in long-term care facilities. They experience fewer health problems as a result of a more focused care plan.

Watch this space for more about this up-and-coming model of care -- including a deeper dive into how agencies can leverage the right technology to help ensure its success.

Topics: Australia, Canada, United States, Industry News