This Dutch approach provides community solutions to home-care needs

From its humble beginnings in a small city in the eastern Netherlands, a method of home care called Buurtzorg has inspired countries around the world to put patient care first.

Jos de Blok, the creator of Buurtzorg — which is Dutch for “neighbourhood care” — worked as a nurse and manager for a home-care organization for several years. In 2006, he and a small team of nurses began practising a more direct approach of community-based care for individuals in need of home-care assistance in the small Dutch city of Almelo.

“My idea was that we could improve the quality of health care by giving health-care workers, [specifically] the nurses, the autonomy and ownership of deciding what has to be done and how [to] do it,” says de Blok.

In a radical shift away from care practices caught up in bureaucracy and procedures, de Blok created a home- care method that prioritizes direct patient care.

Buurtzorg’s hallmark is a consistent neighbourhood care team of about 12 professional nurses who provide home care to between 50 to 60 people within a designated area.

Each nurse meets with a patient and their caregivers, including family, to determine what they require during visits and follow-up. That nurse is then empowered to create a unique care plan appropriate for that person, collaborating with their team and other local health-care specialists, like physiotherapists and psychiatric nurses, when needed.

“It is this kind of circular process every time,” says de Blok. “The assessment and the holistic care is on hand, and the one who’s responsible for delivering the care is also responsible for planning and coordinating care.”

Nurses are expected to spend 60 per cent of their time on shift directly interacting with the client and addressing their needs, instead of reporting or attending meetings. During visits, nurses are equipped to provide a variety of services, as opposed to more traditional home-care methods where specific tasks are performed by specific people. For example, a nurse may clean out the fridge and have a cup of coffee with a patient during one visit and then subsequently do wound care while visiting on another day.

The approach is making an impact. In a study by KPMG, Buurtzorg ranked among the best home-care agencies in the Netherlands on measures of patient-reported experiences. A study by Ernst & Young found that the holistic approach of its nurses proved to have higher productivity during visits.

The Buurtzorg method is currently being used and tested in 25 countries, including Canada.

“All over the world we have neighbourhoods — it’s not about the city, it is about [creating] an environment,” says de Blok. [ ]