Scabru17 buurtzorg ard leferink
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Transcript of Scabru17 buurtzorg ard leferink
Reinvention of a comprehensive community
care model and learning from copycats
Ard Leferink
23th February 2017
My pre-Buurtzorg experience (1)
• Fun!
• Lot of responsibility
• Satisfied customers
• Problem? Let’s solve it!
• No management involved….
My pre-Buurtzorg experience (2)
• Business & Public administration
– Consultant in a large home healthcare organisation
• ’Our’ Analysis – Homehealthcare 1995
– We need to act more like a business
• Bring in the business managers
– Workforce is not flexible and efficient enough
• Bigger teams, smaller contracts
• Splitting up tasks. Managing on time and task
• ERP, Orderfulfillment.
– Customer (not patients!) needs more focus
• Central smart planning, Callcentre
My pre-Buurtzorg experience (2)
• We did it all:
– Business Proces Management
– Project Management
– Customer Relationship Management
– Supply Chain Management
– Business Intelligence
– Human Resource Management
• And the board was happy with it
• Fun!
• Lot of responsibility
• Satisfied customers
• Problem? Let’s solve it!
• No management involved….
• A lot of management involved
• Dissatisfied professionals
• Dissatisfied customers
• Risk? Let’s avoid it!
• Problem? Let’s manage it!
The birth of Buurtzorg : 2006
The birth of Buurtzorg : 2006
Strong vision on
care
Self organising
teams
ICT Backbone
Start Buurtzorg 2006
Starting an organization and care delivery
model for home visiting personal and nursing
care with:
– independent teams, maximum of 12 nurses
– who organize and are responsible for the
complete process:
• clients, nurses, planning, education and finance;
• and all kind of coordination activities!!!!
(Self)-Organisation
• Optimal autonomy
• Complexity reduction (also with the use of ICT)
• Maximum of 12 nurses a team, 40 à 50 clients
• Assessment and taking care of all types of clients:
generalists!
• 50% Bachelor educated nurses
• Their own education budget
• Informal networks are much more important than formal
organizational structures
What started with one team
• In the city of Enschede
• Exploded within 10 years
– 900 teams throughout the country
– 9000 employees
– 300 mln € turnover
– 50 backoffice employees
– 20 coaches
– 1 CEO
How we support the teams
Supporting the independent teams
Supporting the independent teams
• Design :
– Always fight the complexity monster
• Culture :
– Creating the right service culture is tough but
the maintenance is even tougher
IT Strategy
• SCRUM / Agile
– listening to the teams
– Iterative and incremental development
of software
• If Buurtzorgteams don’t like it, IT’s not good
enough!
Double Agile
Agile Business
Development
Agile IT Develop-
ment
Platform as a Service
Buurtzorg as launching customer
No investements in IT
Just ordering services
IT Services: A lot of ‘regular stuff’
Documenting care
Team performance
My most important ‘IT’ lesson
• Social communication is extreme
powerfull.
• But can only develop in a social
organisation that can handle it.
• And only when it’s fully integrated
in regular work
Corporate ??
What we don’t do
• No strategy meetings. In fact, no structured meetings at
all….
• No policymaking
• No (team)budgetting
• No formalized management of…
– Customer relations
– Supply chain
– Human resources
– Communication or Public Relations
– ....
What we do
• Performance monitoring
• Procurement & following new legislation/regulation
• Learning from trends, discussions. (Knowledge System)
• Stimulating innovation & learning
• Coaching ’on demand’
• Quality System
– Focus on what nurses should do, not on how nurses should do that
– Roles and activities
– Buurtzorg acadamy
Effect
Satisfied employees
• Thousands of nurses quit their job at traditional
organizations and went to work for Buurtzorg
• They appreciate:
– Working in small teams
– Working autonomous
– Independency
– Strong team spirit
– User-friendly ICT
• Price for best employer
Satisfied clients
• Good quality of care
• Compared to 307 other organizations for
community care they give the highest score
to Buurtzorg (NIVEL 2009)
Lessons learned From Copycats
Often heard….
• Our people aren’t suited for self organizing, we’ve got the
wrong ones…
• We want best of both worlds.
• Easy job. Just fire the managers and tell the teams they are
in charge now.
• It can be done without restructuring the backoffice.
• It won’t work, it’s just a hype.
The answers….
• Our people aren’t suited for self organizing, we’ve got the
wrong ones…
– Start with the innovators and the early adopters !
– Yes, in the end you’ve got a problem with the Laggards.......
The answers
• We want best of both worlds. (Let’s manage self
organisation)
– You can’t manage the new direction.
– You can only serve, guide and cut complexity.
The answers
• Easy job. Just fire the managers and tell the teams they are
in charge now.
– You’ve got to work hard if your culture isn’t social. And you can’t
schedule a culture change…
– Most difficult part is restructuring the ’backoffice’ (PR, HRM, FM,
etc...)
– It’s not anarchy, you need a clear framework
– Think of a Proof of Concept with a Minimal Viable Backoffice
The answers
• It can be done without
restructuring the backoffice.
– Not true! Cutting complexity,
redesigning processes and delete
the right protocols and procedures is
hard work!
The answers
• It won’t work, it’s just a hype
• Avoid too much theory.
We’ll see…..
Thank you for your attention