District nursing using neighbourhood care principles in practice: reflecting on our experience
There is much interest in the UK, and elsewhere, in the Dutch Buurtzorg model of providing district nursing, and there a number of published, external evaluations of pilot projects. We are nurses who worked in one such pilot that used an adapted Buurtzorg model called neighbourhood nursing using neighbourhood care principles. This article reflects on our experience and describes how we organised ourselves and, our experiences of working in such ways as well as the challenges. This article also offers advice for others who are considering introducing such models
There has been a lot of interest in the model of district nursing provided by the Buurtzorg social enterprise organisation in the Netherlands. While there have been external evaluations of pilot projects of adapted Buurtzorg models in the UK (Drennan et al, 2018; Lahni et al, 2019; Leask, 2020), we would like to share our experiences as nursing staff who have worked in this model. The Buurtzorg organisation principles for district nursing teams are outlined in Box 1.
Box 1.Principles of the Dutch Buurtzorg organisationThe Buurtzorg organisation uses a two-pronged approach to improve patient and staff experience. The first principle is a patient-centred model of care, described as the onion model with the patient at the heart, which delivers health and social care services by the same community nursing team. Core elements of this model include ensuring continuity with a named nurse (or two at most), giving patients and families the skills to be self-managing, providing health and social care, and drawing on community resources to support patient self-management. The second principle is self-managing teams of nurses and assistants of equal status in the flat, non-hierarchical team, supported by coaches, who are not managers. A central tenet is ‘humanity over bureaucracy’, that is, giving authority and responsibility to the frontline nurses supported by small functional back-office without creating tiers of management and associated expensive overheads (Kreitzer et al, 2015).
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