Name of the project

1
Name of the project and Sub-Objective of the
PEOPLE project

• NEIGHBOURHOOD CARE AND NEIGHBOURHOOD CARE WEB /
  BUURTZORG AND BUURTZORGWEB
• E-health independence (SO2)and Social
  e-inclusion (SO4)

2
Objectives of the project (1)

• Developing an innovative, small-scale concept
  for home nursing and care. To this end,
• Buurtzorg provides a number of services to GPs
  aimed at increasing the cohesion in care
  provision
• Buurtzorg neighbourhood care wishes to promote
  the combining of functions by
• neighbourhood care teams and GP's practices. This
  contributes to improved care quality, makes the
  work more enjoyable and leads to the more
  effective organisation of care. It also gives GPs
  more influence on the manner in which care at
  home is carried out

3
Objectives of the project (2)

• Care should be provided entirely by highly
  educated district nurses and district nurses in
  small, autonomous 'Buurtzorgteams'
  neighbourhood care teams which makes improved
  use of their problem-solving capacities and the
  staff's professionalism
• Keeping management costs and overhead as low as
  possible which enables better care to be provided
  at lower cost which provides an appealing
  perspective to the clients, professionals and
  insurers
• Offering better, more durable and effective
  solutions to clients for the implementation of
  modern, supporting ICT applications which enable
  administrative costs to be kept to a minimum.

4
Beneficiaries (involved concerned)

• Buurtzorg Nederland is the initiator of the new,
  neighbourhood-oriented home care concept and
  together with ICT company ECare it has developed
  and implemented the supporting ICT system
  Buurtzorgweb neighbourhood care web.

5
Results of the project (1)

• A neighbourhood-oriented home care concept which
  closely involves the neighbourhood with the care
  professional as the case manager using a
  supporting, web-based neighbourhood platform and
  ICT functionalities (Buurtzorgweb) for care
  registration and communication in the chain and
  with clients and informal care providers. A
  neighbourhood scan has been developed to
  catalogue and publish the facilities per
  neighbourhood on the neighbourhood platform's
  website. Communities for e-learning have also
  been founded to keep staff expertise up to
  scratch on the basis of knowledge circles
• The basis for the concept has proven itself in 75
  neighbourhoods where small teams of 10 to 12
  staff provide help with high levels of customer
  satisfaction, as is the case in the province of
  Noord-Brabant. In 2008, 750 staff started working
  for Buurtzorg in 75 teams which provided care to
  2,000 clients

6
Results of the project (2)

• Nivel has compared Buurtzorg clients' experiences
  to those of clients of other home care
  organisations. The clients are enthusiastic, the
  quality of care is described as high. The good
  telephone accessibility, the professionalism and
  the safety of the care provided are conspicuous.
  Buurtzorg received the highest score from clients
  of all home care institutions (308 in total). The
  Nivel researchers conducted interviews with
  staff, informal carers, clients and GPs, and
  analysed the interviewed clients' surveys. The
  clients' experiences were compared to those of
  well over 9,500 clients of 307 other home care
  organizations

7
Results of the project (3)

• Buurtzorgweb provides immediate support to the
  staff in their daily work and transforms them
  from digitally illiterate people into pioneers in
  the field of e-health. It raises the
  selfdirecting capacity of the home care staff and
  moreover the system leads to considerable
  savings. The website is initially used for
  registering hours and scheduling. Furthermore,
  the site provides all manner of functionality
  which helps the staff with their daily work such
  as a digital social map so that they can quickly
  see which facilities exist in the client's
  vicinity. It also allows the staff to chat,
  discuss and exchange knowledge with one another
• The concept is now being scaled up to 150
  neighbourhoods due to the further development of
  Buurtzorgweb with financial support from the
  government.

8
Strengths of the project 

• Self-directing capacity of carers as point of
  departure
• A demand-oriented and personal approach to
  clients
• Small, autonomous teams which guarantees
  personal, flexible service whereby a limited
  number of carers visit people at home
• Neighbourhood-oriented approach which enables
  more knowledge of the neighbourhood's social
  networks and the improved utilisation of and
  cooperation with informal care
• Low overheads which create low organisational
  costs and more room for arrangements and own
  responsibility for carers in the care provided to
  clients.

9
Success factors of the project (1)

• Utilisation of ICT functionality and the
  neighbourhood platform which allows more rapid
  communication with the carers in the chain,
  clients and informal care providers in the
  neighbourhood and allows the work to be carried
  out more efficiently. This enables clients to be
  helped better and more cheaply on the basis of a
  small-scale home care concept
• The return of permanent contacts per
  neighbourhood and cooperation with GPs who are
  very enthusiastic about and satisfied with the
  accessibility and the Buurtzorg teams' permanent
  contact

10
Success factors of the project (2)

• Explicitly steering towards less care than
  indicated instead of depleting budgets. Having a
  good eye for what the client really needs linked
  to professional judgment is what the client
  wants, feasible and desirable from a care
  perspective
• The concept is supported and stimulated by the
  government, insurers, political parties and the
  municipalities.

11
Problems occurred (1)

• Large-scale home care organisations are not
  sufficiently open to Buurtzorg's small-scale
  concept. That is why a foundation was started by
  a social entrepreneur based in the professional
  group. This is a shame in a way, however
  simultaneously it is also a good means of
  properly and purely demonstrating the strength,
  viability and advantages of a different,
  small-scale way of organising home care. These
  fellow organisations have responded aggressively
  and have attempted to obstruct Buurtzorg's work
  and block channels to hospitals. The dismantling
  of organisations by focusing on professional
  points of departure and care values is
  encountering hostility
• Difficulty being accepted by care offices due to
  suspicion

12
Problems occurred (2)

• The change in criteria from a production-driven
  to a more context-driven approach takes time to
  sink in at care offices and insurers
• Changes to government regulations and the new
  definition with regard to focusing on
  clientprofessional relationship take time
• Pre-financing the supporting technological
  system requires substantial investment from the
  organization which makes a subsidy essential.

13
Conclusions (for the future)

• The Buurtzorg concept for the small-scale
  organisation of home care is feasible, in part
  thanks to the supporting ICT of the Buurtzorgweb,
  and provides quality improvement and cost
  reduction in home care which allows more people
  to be helped in a very demand-driven,
  customer-friendly manner.

14
Replication of the project

• Buurtzorg supported by Buurtweb will be rolled
  out in 150 neighbourhoods in the
• Netherlands with support from the government
• Large-scale home care organisations can learn
  from the Buurtzorg concept and broaden the
  concept on the basis of this by reorganising into
  smaller-scale neighbourhood teams using ICT
• Buurtzorg wishes to contribute to narrowing down
  the debate concerning the effects of the current
  structure of the care system.