How They Do ItBETA
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COMPANY PLAYBOOK

Buurtzorg

Buurtzorg places care coordination in small nursing teams and relationships close to the client’s daily life.
Operating system
  1. Client perspective
  2. self-managing team
  3. continuity of care
  4. trusting relationship
  5. neighbourhood network.

System principles

  • Organize care around client independence.
  • Own team outcomes collectively.

Tensions and trade-offs

  • Consensus increases participation but can lengthen decision-making.

PRACTICES

How Buurtzorg builds its operating system

01
Self-management

Collective team accountability

Team members are collectively responsible for team results.

How it works
The team, rather than an individual manager, carries responsibility for the result.
Why it is used
It keeps decisions with practitioners closest to care.
Trade-off
Collective accountability can leave ownership unclear without disciplined coordination.
Best fit
Small professional teams with shared work.
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02
Decision making

Consensus team decisions

Team decisions are made by consensus.

How it works
Members seek agreement rather than relying on a manager’s directive.
Why it is used
It gives those delivering care a voice in how it is organized.
Trade-off
Consensus is demanding when urgency or disagreement is high.
Best fit
Decisions where affected team members can deliberate.
Open original source ↗
03
Care delivery

Continuity and neighbourhood networks

The model treats trusting relationships and neighbourhood networks as care principles.

How it works
Teams organize care around continuity, trust and local connections.
Why it is used
It supports client independence rather than fragmented service encounters.
Trade-off
Relationship-building requires time that throughput measures may undercount.
Best fit
Community care with repeat contact and local partners.
Open original source ↗
04
Care delivery

Make client self-management a care objective

Care planning starts from solutions that increase the client’s independence and quality of life.

How it works
The onion model assembles needed solutions outward from the client perspective.
Why it is used
Connects service delivery to the client’s everyday outcome rather than task completion.
Trade-off
Individualized coordination can reduce standardized throughput.
Best fit
Care services where continuity and functional independence matter.
Open original source ↗
05
Documentation

Embed a common care taxonomy in the information system

The research-based standardized Omaha taxonomy is integrated into Buurtzorg Web to support care recording and coordination.

How it works
A shared taxonomy gives teams one structure for health problems, interventions, and outcomes.
Why it is used
Makes care information comparable and transferable across teams.
Trade-off
A standard taxonomy can constrain local, nuanced narrative.
Best fit
Health systems needing shared care records across distributed professional teams.
Open original source ↗

Primary sources