Interview of Jos de Blok from the Buurtzorg Dutch nursing company

I had the opportunity to interview Jos de Blok from the Buurtzorg Dutch nursing company, which is described as a great « Opale company » by Frédéric Laloux (cf his book Reinventing organization) 

Can you explain the reasons why you have created Buurtzorg? 

I worked for 16 years as a nurse. I was very critical about the way our job was organized. Quality was getting worse and worse, the client’s satisfaction was decreasing and the expenses were increasing.

The management were not supporting the quality. Managers were very busy with the management, and not considering the interests of the patients.

I thought it was possible to do it differently and much better, with lower costs and better job satisfaction for nurses. I left my job and developed a new model based on completely different principles:

  • autonomy of nurses
  • flat organisation
  • low back office cost
  • smart IT system: integrated IT system for exchanging information

Karen Monsen wrote an article on your company, analysing it as the Design Thinking approach, that you posted on your website http://www.buurtzorgusa.org/wp-content/uploads/2016/03/2013-Buurtzorg-Creative-Nursing.pdf Did you think about Design Thinking when you created your company? 

No, I didn’t know Design Thinking. What I did was just common sense.

What are the difficulties you had to face at the beginning? 

I didn’t encounter many difficulties. I had a lot of support from the start, by talking and explaining my vision, getting the required contract from the Dutch health insurance. Everybody could see that the traditional system was not working well, there was a lot of frustration. People were ready to try something different.

I developed the organization in an organic way with the same values that I had at the beginning. There are teams of 10 or 12 nurses working in the neighbourhood. They organise everything by themselves. They now have 815 teams taking care of the patients.

At Head Office, we have the Back Office, the Administration: 35 employees, including 18 coaches who support and advise the nurses. There is no management system. The teams report to themselves. All the results can be seen in the system. There is a social control of the team. We do not have any manager.

What is your role? 

I ensure that the principles are kept clear, that we do not create any bureaucracy. I focus on continuity, I try to avoid obstacles and I find ways to inspire the nurses. There is a lot a freedom and autonomy. We have been nominated Best Employer for 5 years.

What are the key success factors of your company? 

I don’t make this kind of list. There is no KPI. We just listen very carefully to what is happening in the field and we keep our principles.

Do you think it is possible to change the culture, the organisation and the management practices of a traditional company or is it necessary to start from “scratch”?

I believe that it is more difficult to change an organisation and its culture as opposed as starting from “scratch” but it is possible. Many Dutch companies get inspired by our way of working. The CEO has to be convinced and the Design Thinking approach can help.