Buurtzorg Nederland, a proposal for nurse-led home care

Enferm Clin (Engl Ed). 2020 Nov 10;S1130-8621(20)30496-4. doi: 10.1016/j.enfcli.2020.08.004. Online ahead of print.
[Article in English, Spanish]

Abstract

Buurtzorg Nederland is a Dutch healthcare organization in which nursing teams provide home care in all the skills that affect their profession. This article raises some questions regarding more internal aspects of the organization based on 3dimensions. The first, the organizational dimension, in which the teams are structured based on 8 roles, without hierarchies and supported by the coaching system. The second, the nursing dimension, in which it is highlighted that nurses deal with all the competences that affect their profession, from basic care to more complex care, with the aim of defragmenting care. And the third, the economic dimension, in which it stands out that the sustainability of the organization is in being a system without managers, of small teams that work in small geographic areas, with a computer system that supports all organizational matters, healthcare and financial. The main characteristics of Buurtzorg Nederland are the self-management of the teams and the defragmented care that both the nurse and the patient satisfy. However, this defragmentation has been achieved in terms of patient care, with the same team attending to all basic and complex care needs at home, but at other levels of care it has not been achieved, and the patient must visit other providers, therefore, health care at other levels continues to be fragmented.

Keywords: Delivery of integrated health care; Home care services; Liderazgo enfermero; Nurse leadership; Organización de los servicios de salud; Organization of health services; Prestación de atención de salud integrada; Servicio de atención domiciliaria.