Buurtzorg

As co-founders of home nursing company Buurtzorg, Jos de Blok and Gonnie Kronenberg prized both self-management and organizational learning. Buurtzorg’s 10,000 nurses across 950 neighborhood nursing teams in the Netherlands were empowered to manage themselves, both in terms of client care and team management. In its 16 years of existence, that had made Buurtzorg highly successful and had made its model attractive both for other Dutch companies and internationally. Yet because neighborhood teams managed themselves, so much of what they learned remained in the team. While nurses would sometimes try to spread such solutions to peer nursing teams, such as through calls/texts or the company's internal social network BuurtzorgWeb, there was no holistic, top-down process for reviewing and disseminating best practices across all nursing teams—in part because Buurtzorg had been designed to avoid such hierarchical, top-down management in favor of a more flat, nimble, and minimally bureaucratic organization. They attributed much of the company's success (in terms of high client satisfaction and low employee turnover) to that model. But as the Dutch population aged and the country faced an increasingly dire nursing shortage, nurses would need to work more efficiently than ever, and elevating local, variegated learning to company-wide best practices would be one way to do so. How could Buurtzorg break the tradeoff between prizing self-management and effective sharing of best practices for organizational learning?
By asking students to decide whether and how Buurtzorg's learning model could evolve to better leverage knowledge within the nursing teams without undermining Buurtzorg's flat organization and culture, students will wrestle with the pros and cons of centralization vs. decentralization within organizations. Students will gain exposure to one of the world's foremost examples of organizations that effectively operate in a decentralized, self-managing fashion, yet will grapple with how such an organization can scale learning from the local to the organizational level.