Buurtzorg: Nurse-Led Community Care

Monsen, Karen A.; Blok, Jos de

doi:10.1891/1078-4535.19.3.122

Cited by 35 publications

(49 citation statements)

References 2 publications

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“…501 For example, the Buurtzorg model of care is based on the shared goal of 'humanity over bureaucracy' to provide a sustainable, holistic model of community care; this emphasises connectivity and mutual respect through shared knowledge within an autonomous team responsible of all aspects of care for a group of patients. 53 The theory component of M2 resonates strongly with the Buurtzorg model, in which the shared goal is one of co-ordinated patient-centred care through interprofessional delivery, 345 the clarity of roles and support through reflective practice, 345,502 emphasising team 'belonging'. 315,329,502 The emphasis of the MCP on co-production and community resilience (R3) requires trust, 266 ownership and confidence, 263,274,287 enabling individuals to recognise their reciprocal roles 286 and maintain mutually beneficial relationships.…”

Section: Relational Co-ordination Theorymentioning

confidence: 99%

“…It aimed to provide an accountable partnership with social innovation, 'humanity over bureaucracy', at its core, 52 by attempting to shift the care delivery mindset from managerial protocols and administration to clinical autonomy and accountability. 53 Buurtzorg Nederland was founded in 2006, with a small team of professional nurses, and following 10 years of operation, the model has extended to encompass 10,000 nurses in 850 teams in towns and villages all over the Netherlands, and has spread to a further 24 countries. 54,55 In response to criticisms of 'cherrypicking' of patients in its reporting of cost-effectiveness, the Dutch Ministry of Health, Welfare and Sport commissioned the consulting firm Klynveld Peat Marwick Goerdeler (KPMG; Amstelveen, the Netherlands) to compare Buurtzorg with other home-care providers.…”

Section: Buurtzorgmentioning

confidence: 99%

See 1 more Smart Citation

The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis

Turner¹,

Mulla²,

Aldridge³

et al. 2018

Health Serv Deliv Res

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BackgroundThe Multispecialty Community Provider (MCP) model was introduced to the NHS as a primary care-led, community-based integrated care model to provide better quality, experience and value for local populations.ObjectivesThe three main objectives were to (1) articulate the underlying programme theories for the MCP model of care; (2) identify sources of theoretical, empirical and practice evidence to test the programme theories; and (3) explain how mechanisms used in different contexts contribute to outcomes and process variables.DesignThere were three main phases: (1) identification of programme theories from logic models of MCP vanguards, prioritising key theories for investigation; (2) appraisal, extraction and analysis of evidence against a best-fit framework; and (3) realist reviews of prioritised theory components and maps of remaining theory components.Main outcome measuresThe quadruple aim outcomes addressed population health, cost-effectiveness, patient experience and staff experience.Data sourcesSearches of electronic databases with forward- and backward-citation tracking, identifying research-based evidence and practice-derived evidence.Review methodsA realist synthesis was used to identify, test and refine the following programme theory components: (1) community-based, co-ordinated care is more accessible; (2) place-based contracting and payment systems incentivise shared accountability; and (3) fostering relational behaviours builds resilience within communities.ResultsDelivery of a MCP model requires professional and service user engagement, which is dependent on building trust and empowerment. These are generated if values and incentives for new ways of working are aligned and there are opportunities for training and development. Together, these can facilitate accountability at the individual, community and system levels. The evidence base relating to these theory components was, for the most part, limited by initiatives that are relatively new or not formally evaluated. Support for the programme theory components varies, with moderate support for enhanced primary care and community involvement in care, and relatively weak support for new contracting models.Strengths and limitationsThe project benefited from a close relationship with national and local MCP leads, reflecting the value of the proximity of the research team to decision-makers. Our use of logic models to identify theories of change could present a relatively static position for what is a dynamic programme of change.ConclusionsMultispecialty Community Providers can be described as complex adaptive systems (CASs) and, as such, connectivity, feedback loops, system learning and adaptation of CASs play a critical role in their design. Implementation can be further reinforced by paying attention to contextual factors that influence behaviour change, in order to support more integrated working.Future workA set of evidence-derived ‘key ingredients’ has been compiled to inform the design and delivery of future iterations of population health-based models of care. Suggested priorities for future research include the impact of enhanced primary care on the workforce, the effects of longer-term contracts on sustainability and capacity, the conditions needed for successful continuous improvement and learning, the role of carers in patient empowerment and how community participation might contribute to community resilience.Study registrationThis study is registered as PROSPERO CRD42016039552.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Relational Co-ordination Theorymentioning

confidence: 99%

Section: Buurtzorgmentioning

confidence: 99%

The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis

Turner¹,

Mulla²,

Aldridge³

et al. 2018

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

“…It is a company that is driven by a belief in “humanity over bureaucracy,” and that belief deeply impacts the patients and those who care for them. 3 , 4 As we will describe in this article, this social innovation goes beyond health-care and in many ways reflects whole-systems healing—healing that is oriented to advancing the health and wellbeing of people, families, and communities.…”

Section: The Buurtzorg Modelmentioning

confidence: 99%

Buurtzorg Nederland: A Global Model of Social Innovation, Change, and Whole-Systems Healing

Kreitzer

Monsen

Nandram

et al. 2015

Glob Adv Health Med

Self Cite

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“…In Japan, home medical care is provided by physicians and visiting nurses (Center for Home Care Medicine, Faculty of Medicine, The University of Tokyo 2015). Japan's home medical care is considered to be unique as compared with other developed countries in that physicians play a leading role in care without delegating care to nurses (Monsen and de Blok 2013;Young et al 2016).…”

Section: Introductionmentioning

confidence: 99%

Cooperation between Single-Handed and Group Practices Ensures the Replacement of Gastrostomy Tubes and Tracheal Cannulas in Home Medical Care Settings

Kimura

Yoshie

Tsuchiya

et al. 2017

Tohoku J. Exp. Med.

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In Japan, patients who require home medical care are increasing especially in the elderly. In home medical care settings, devices such as gastrostomy tubes, tracheal cannulas, and urethral catheters are usually replaced by visiting physicians or nurses. However, device replacement services are not always available in Japan. Unless device replacement services are sufficiently provided to patients at home, patients have to suffer various disadvantages, including a forced visit to a hospital for device replacement despite inability to walk. We therefore investigated background factors of clinics and nursing stations providing home-care visits using a cross-sectional postal survey from August to September 2013. We targeted physicians from 5,828 clinics providing home medical care and nurses from 1,798 home-visit nursing stations across six prefectures (Tokyo, Kanagawa, Saitama, Chiba, Miyagi and Iwate). Responses were received from 933 clinics (16.5%) and 552 stations (31.3%). We analyzed the responses using multivariable logistic regression with two models. "Model 1" mainly included the number of full-time staff and the availability of a 24-hour care service system, and "Model 2" mainly included the number of clinics, the number of home-visit nursing stations, and the ratio of the population aged ≥ 65 years to study the influence of medical resources. We thus found that clinic staff numbers and 24-hour care availability were associated with physicians' replacement of gastrostomy tubes and tracheal cannulas (p < 0.001 for each). In conclusion, single-handed and group practices need to cooperate to ensure the replacement of these devices in home medical care settings.

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Buurtzorg: Nurse-Led Community Care

Cited by 35 publications

References 2 publications

The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis

The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis

Buurtzorg Nederland: A Global Model of Social Innovation, Change, and Whole-Systems Healing

Cooperation between Single-Handed and Group Practices Ensures the Replacement of Gastrostomy Tubes and Tracheal Cannulas in Home Medical Care Settings

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