eu models of care eu models of care webinar – introducing buurtzorg 17 september 2015
TRANSCRIPT
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EU Models of Care
EU Models of Care webinar – introducing Buurtzorg
17 September 2015
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NHS European Office
• Who are we?– Established 2007– Part of the NHS Confederation– Funded by national NHS bodies
• What do we do?– Represent NHS organisations in EU policy-making and legislation– Assist the NHS with the implementation of EU law– Offer strategic advice on EU funding opportunities– Promote partnerships between NHS organisations and bodies from
other sectors/countries
www.nhsconfed.org/europe
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EU Models of Care
• Working with NHS England to support Pioneers and Vanguards to develop links and share learning with organisations at leading edge of integrated care in Europe
• An in-depth look at four different EU Models of Care throughout 2015-16:
• Spain (Alzira)• Netherlands (Buurtzorg)• Sweden (Jonkoping)• Germany (Gesundes Kinzigtal)
• Webinar, followed by study visit – look out for the registration links
• EU Models of Care conference in spring 2016
• Other events and activities throughout the year
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• Integrated Care Model Pillars
1LEADERSHIP
AND EXECUTION
2PERSON-CENTRED
MODELS OF CARE
3WORK-FORCE
Agile and supported
4OUTCOMES
AND QUALITY
INCENTIVES
5CULTURE
Empoweringcontinuous
improvement
6 ENABLING CAPABILITIES
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Understanding the Buurtzorg model
Jos de BlokDirector
Buurtzorg
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Jos de Blok
Buurtzorg: community based integrated care in a teal organization.
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Buurtzorg – Quick Scan
• New organization and care delivery model• Started in 2007 with 1 team/4 nurses• Delivering Community Care/working together GP’s• 2015: 9500 nurses in 800 ‘independent’ teams.• 45 staff at the back office and 15 coaches• 70.000 patients a year
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Results policy on homecare 2006
• Fragmentation of cure, care, prevention • Standardization of care-activities• Lower quality / higher costs: wrong incentives:
delivering much care against low cost is profitable • Big capacity problems due to demographic
developments (shortage of 400.000 nurses within 10 years)
• Clients confronted with many care givers• Information on costs per client/outcomes: none!
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Start Buurtzorg 2007
Starting an organization and care delivery model
for community care with:– independent teams of max 12 nurses – Working in a neighborhood of 5000-10.000 p. – who organize and are responsible for the
complete process:• clients, nurses, planning, education and finance; • and all kind off coordination activities!!!!• Integrating nursing/medical and social care
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CLIËNT
4. Formal networks
2. Informal networks
3. Buurtzorgteam
1. Selfmanagement client
Onionmodel Buurtzorg
Buurtzorg works inside-out: empowering and adaptive, network creating, supporting.
Vision: support indepence!
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(Self)-Organisation
• Optimal autonomy and no hierarchy: TRUST• Complexity reduction (also with the use of ICT)• Max of 12 nurses a team, 40 à 50 clients• Generalists: taking care for all type of patients• 70% registered nurses/40% bachelor degree• Their own education budget• Informal networks are much more important than
formal organizational structures• Training SIM: selfsteering and coaching
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Different types of clients
• Chronically ill and functionally disabled clients• Elderly clients with multiple pathology• Clients in a terminal phase• Clients with symptoms of dementia• Clients who are released from the hospital and are
not yet fully recovered
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Quality system
• Monitoring outcome instead of production: the Omaha system
• Roles and activities instead of processes (DK)• High education level: 70% is RN (average 10%)• And of course: client satisfaction!
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Supporting the independent teams
• 45 people in 1 back office; 15 coaches, managers 0!
• Taking care of inevitable bureaucracy, so the nurses won’t be bothered with it!– The care is charged. – The employees are paid– Making financial statements
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ICT makes it possible! - Buurtzorgweb
Grip on the business
Position in the care-chain,relationship with other care givers.
View on quality of care,transparency
Shared values Community
Instruments
Communitation in the care chain
Production
Relationship professional
and client
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Buurtzorgweb – some aspects
• Community• Clients and employees data• Hour registration. • Sharing documents• All the necessary administration for accountability
to cost providers, inspection etc. • Planning
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Community • Shared values. Nurses work all over the country
but feel like ‘one’• Nurses can ask for good examples from colleagues
all over the country.• Man. Dir. can easily check the ideas of the teams• The back office has an easy way of communication
with all the nurses • Contact between nurses and informal care and
other caregivers from the neighborhood
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Buurtzorg is Dutch most fast growing organization
Started in 2007 2015: 8000 nurses in 800 teams
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Buurtzorg in the whole country
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New theoretical model?
Frederic Laloux: reinventing organizations:• Self-management• Wholeness• Evolutionary purpose
Sharda Nandram: Integrating simplification• Needing principle• Rethinking principle• Common sense principle
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Satisfied employees• Thousands of nurses quit their job at traditional
organization and went to work for Buurtzorg• They appreciate:
– Working in small teams– Working autonomously– Independency– Strong team spirit– User-friendly ICT
• Price for best employer 2011/2012/2014/2015?
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Satisfied clients
• Good quality of care.• “Compared to 307 other organizations for
community care they give the highest score to Buurtzorg. (NIVEL 2009)“
• Highest client satisfaction rates: 9,1• Supported by patient- and elderly organizations• Less admissions in hospitals and nursing homes
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Radio Steunkous
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http://www.youtube.com/watch?v=Q-fPDrN5pBU
Rollatorrace
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Cost effectiveness for the organization
• Overhead costs: 8% (average 25%) more money for the care and innovation
• Profit rate: 4%
• Sickness rate: 4% (average 6%)
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Cost Benefits for the Care! • The home care would be 65% of the costs (Buurtzorgs
model leads to more prevention, a shorter period of care and less spending on overhead)
• More satisfied employees and clients
• The government an all political parties are stimulating other care organization to work like Buurtzorg.
• Other sectors are interested in the organization model
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Is England ready for a transition?
• There are persistent problems in health care: • - quality: fragmentation• - demographic and costs: exploding?• - human capital: frustrated professionals • Problems can’t be solved with current solutions• Public world is coordinating Buurtzorg activities in
UK together with Resolis (Scotland)
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Thank you for your attention
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Understanding the Buurtzorg model
Any questions?
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Next Steps
• We will:
• Share the recording • Organise a study visit to the Netherlands soon• Follow up with colleagues interested in developing direct links with Buurtzorg– please
talk to your account management team to incorporate into your support planning• Share webinar evaluation survey – please do complete!https://www.surveymonkey.com/r/YMR3GX8
• Next EU Models of Care examples:• Jonkoping webinar – 19 October at 12.30 UK timehttps://attendee.gotowebinar.com/register/3395771662321356545 • Gesundes Kinzigtal webinar – 26 November at 11.30 UK time
For more information, please contact: [email protected] or [email protected]