OYK enjoys Amsterdam.
3d ·
Came to Amsterdam to study Buurtzorg. “Buurt” means neighbourhood in Dutch, while “zorg” means care. They are the largest community nursing provider in Netherlands, with 15,000 nurses looking after 100,000 patients at home.
Buurtzorg started due to a policy change in the early 1990s. The Dutch government, in trying to rein in healthcare costs, stipulated rules that effectively require ‘lower value added’ tasks like bathing patients to be done by health assistants, while ‘higher value added’ tasks and clinical procedures were to be done by registered nurses. The result was a fragmentation of roles, and ballooning of administrative load to enforce these rules.
Jos de Blok, a community nurse, then decided to start Buurtzorg, a non profit community nursing organisation, to bring back the old practice. The nurses are organised into teams of 12, with a flat hierarchy and autonomy to plan and deliver care. Each team is largely self-regulated.
Since then, Buurtzorg’s organisational and operating model has been closely studied and written into books and case studies.
Today, the ratio of institutional vs community care nurses in the Netherlands is about 1:1. In Singapore, the definitions are different but we are definitely lower, at perhaps 3:1. It reflects a different philosophy of care, which has been traditionally centered around institutions like hospitals and polyclinics.
But with the emphasis on population health and preventive care, Healthier SG and Age Well SG, the proliferation of Active Ageing Centres, Community Health Posts and home nursing and palliative care, healthcare delivery is gravitating towards the community. Models like Buurtzorg become very relevant to us.
In the award-winning series Ted Lasso, the coach came to Amsterdam and discovered Total Football, where there is no fixed formation – players in the defence, midfield and attack change roles during the game to cover each other.
Our team came to Amsterdam to be inspired to realise the vision of Total Healthcare, where tertiary, secondary, primary, community and home care are well integrated and complement each other to provide holistic care for patients. It is what an ageing population needs.
To succeed, we need conditioning, versatility, awareness and a fourth quality which MOH will have to determine along the way.
