Buurtzorg Communities of Performance

I’ve written a 3 page feature for HR Magazine this month (this edition also has me on the cover as one of their ‘Movers and Shakers’).

The feature focuses on the creative design of people centric organisations and summarises some of ‘The Social Organization’. Therefore, if you’ve not read and don’t want to read the book (you should!) you can at least read the summary of the section on organisation models in HR Magazine.

However, I’ll also be outlining a lot of the main points from the book and the article here. I’ve already reviewed the advantages and disadvantages of traditional organisation models and the first more people centric model: communities, and especially communities of performance. If you're not read this article, I recommend you do so before reading this post.

In 'The Social Organization', I include a case study on self-directed communities at Buurtzorg. This is a well known maverick organisation and I chose it deliberately as an example many people would have already heard of to illustrate that I don't think it's a case study of what people generally think it is one of (indeed, what it is presented as by Buurtzorg itself).

For me, it's not an example of self managed / organisation teams, it's a case of what I've just been discussing in my previous article, communities of performance. For me, the difference between a team and a community is much more important than the distinction between managed and self managed.

Buurtzorg is a Dutch organization of 9,000 community nurses. Built on trustful relationships and the idea of placing humanity above bureaucracy, it operates through self-directed groups of 10 to 12 people, each looking after about 50 patients within a neighbourhood. These groups are responsible for the complete care process within that area. However, nurses focus on individual patients, getting to know them and supporting them at a personal level, and so the process does not predominate as it does at, for example, Cleveland Clinic (reviewed in Chapter 7). Groups also decide how they will deliver this care, including how many patients to support, which partners to work with, where to rent an office, and even whether they need to expand the group or split it in two. This may happen if a group is getting too big and people are finding it more difficult to coordinate their activities. There are no managers, so responsibilities for all these decisions are distributed across the nurses within a group.

Not only is there no group managers but there is no regional management either. There are coaches but these have no responsibility or decision-making authority over the groups. Coaches cover 40–50 groups, which stops them getting too involved and ensures that groups remain independent of them. There are also no staff functions, eg HR, although experts are sometimes hired centrally to work in advisory roles on a contract basis, often to build up the nurses’ own capabilities so the experts become surplus to requirements.

However, people are not treated equally and decisions are not made by consensus. Nurses take leadership roles within their teams or the whole organization where they have particular expertise, interest or can make the greatest contribution. Groups are also linked through an organizational network, allowing nurses with particular specialisms to share their expertise outside their own community or to participate in voluntary task forces. However, these additional contributions are made based upon the individual person not just because of the role they are operating in, as it would be in Zappos, for example.

Also, instead of having a formal set of principles, as found in Zappos’s constitution, Buurtzorg just has a few ground rules, which include, for example, the need for group members to appraise each other every year. However, groups decide how they are going to do this for themselves in order to ensure local ownership of their appraisal process. People cooperate easily and there is little need for structured meetings. CEO Jos de Blok shares ideas through a blog for developing the company – and these posts may eventually lead to agreement on a new policy.

Buurtzorg call their groups ‘teams’, but it is evident to me that the company is a community-not a project-based organization, internally as well as externally (ie the nurses work within internal communities as well as supporting their external communities). The company is able to make these internal communities work effectively for business purposes because their nurses are so intrinsically motivated, something that is supported by both the organization’s social purpose and its self-directing approach.

Please let me know your thoughts and I'll share more on communities and networks shortly...

Here are my previous posts on organisation models:

https://www.dhirubhai.net/pulse/hr-magazine-new-organisation-models-jon-ingham/

https://www.dhirubhai.net/pulse/whats-wrong-traditional-functions-why-do-most-still-use-jon-ingham/

https://www.dhirubhai.net/pulse/from-vertically-focused-functions-horizontal-cross-teams-jon-ingham/

https://www.dhirubhai.net/pulse/making-matrices-work-jon-ingham

https://www.dhirubhai.net/pulse/communities-performance-jon-ingham

Jon Ingham, @joningham, https://linkedin.com/in/joningham, [email protected], +44 7904 185134.

Top 100 HR Tech Influencer - Human Resources Executive

Mover and Shaker - HR magazine

Jon Ingham, @joningham, https://linkedin.com/in/joningham, [email protected], +44 7904 185134.

Top 100 HR Tech Influencer - Human Resources Executive

Mover and Shaker - HR magazine