Jos de Blok

Ashoka Fellow
Fellow Since 2015


This profile was prepared when Jos de Blok was elected to the Ashoka Fellowship in 2015.
The New Idea
With an increasingly aging population in the Netherlands and around the world, developing new and efficient ways to provide care for the elderly is a growing imperative. Considering that hospitalization is costly, the challenge is to provide efficient but effective models of delivering patient centered care. Recognizing the crucial role that nurses play in driving the wellness of patients, Jos provides an alternative grassroots model for home-care that places nurses and patients at the helm of decision making in care-delivery. With this model, Jos has not only created a way for patients to get better care and avoid hospitalization in the long run, he also paved the way for nurses to be central forces in healthcare delivery.

Jos believes that by nature, nurses are intrinsically motivated to work towards the betterment of their patients. By ensuring that they have autonomy, nurses would be able to act on this motivation and strive to find the best possible solutions for patients. With this in mind, Jos has created the architecture for a network of self-steering teams of nurses in communities that are empowered to work with patients to devise solutions to their home-care needs.

Through his organization, Buurtzorg (meaning “neighborhood care”), a network of over 8000 nurses organized into about 500 smaller autonomous teams work together to meet their patients’ needs. Within each neighborhood, the independent teams of nurses are responsible for the complete care delivery to their patients. Central to this approach is ensuring that these nurse teams have a high degree of autonomy to carry out their work. Because they understand that they are wholly responsible for the well-being of their patient, nurses take greater ownership over their work, and thus seek to provide only the best possible care. To do this, they share patient solutions, results and experiences with one another. A specialized digital platform facilitates this communication, linking not only nurses within a team but also to other nurses in the broader Buurtzorg network. This platform works across all aspects of care-delivery -- linking also to doctors and pharmacists outside the network to ensure sharing and proper management of patient information. The combination of autonomy given to nursing professionals and the use of a specialized internal intranet, enable Buurtzorg to be a leaner and more responsive model for homecare.

Traditional home-care models are often laden with expensive managerial layers and bureaucratic processes. They determine to a large degree what can and cannot be done for a patient. Instead of using the patients’ needs as the starting point for finding the best solution, cost reduction often becomes the main determinant of the kind of care patients receive. Jos’ model challenges this approach, by showing that care can actually be holistic and responsive and at the same time, have massive efficiency and cost-saving implications. Although it requires higher costs per hour, Jos’ model overall requires fewer hours in the long run. A 2012 KPMG study showed that “by changing the model of care, Buurtzorg has accomplished a 50 percent reduction in hours of care, improved quality of care, and raised work satisfaction for their employees." Furthermore, such a transformation in system ultimately resulted in a reduction of per patient costs, between 20-30 percent (Ernst and Young).

Believing strongly in the transformative capacity of supporting the self-management capabilities of professionals in a community and combining this with an integrated approach to localized informal and formal care systems, Jos envisions that the model can eventually be applied to other localized care systems – including psychiatric care, post-natal care, hospices and elderly home.

Currently, Jos’ idea is in use in the Netherlands, and spreading into Japan, Belgium, Sweden and now the USA.
The Problem
The Strategy
The Person

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