VoorZorg Thuiszorg, the road to community-based, multidisciplinary and self-managing teams for which the client is key

2016 – In this group of three non-profit associations in the province of Antwerp, Belgium, 900 employees deliver health care, home care and domestic help. Since 2014, this organization is carrying out an organizational change with external support from Flandres Synergy (FS). In the FS Members Magazine, in the section Good Practices an article was published about this case. This article is summarized below. 

Workplace innovation
VoorZorg Thuiszorg wants to reach that the work is done in community-based, multidisciplinary and self-managing teams for which the client is key. The now strongly hierarchical organization with four layers of management will be simplified; there will remain two layers, namely the community teams and a supportive management team. To facilitate cooperation within the teams the electronic patient-file will be introduced and all employees will get a laptop and a smartphone. They will be trained to work in the new way and with the new resources. 

Drivers

The management became increasingly convinced that collaboration between disciplines, roles and non-profit organizations is necessary in the care. At the same time government called for decentralization and small scale organisation, close to the client.
The management realized that if you demand employees to work together and expect them to show more initiatives, then you need to provide a structure that provides room to do so. 

Approach
In December 2014 a two-day launch conference was held, in which 60 employees participated. These were people from all regions and of all disciplines and hierarchical layers. At that conference the direction became clear. They wanted to work in local, community teams that focus on the client. Also some principles were formulated: diversity, openness and respect.
January 2015 a Design team with 20 participants from the 60 was formed, as well as a Steering committee consisting of Advisors and Management. These two groups firstly formulated a vision and then outlined a new structure. The latter was the most difficult job, because ‘the old structure continues to dominate in your head’. But in the end the result was a very simple structure of community teams in all 44 districts and a supportive management team. In September 2016, the implementation started, first in two regions with respectively 3 and 4 community teams. In the beginning of 2017 members of the Steering committee will visit all districts to talk about the plans. The management realize that it can look and feel like an ‘eclipse’, but reassure that ‘the sun will shine again afterwards’. It is intended that all community-teams have started at the end of 2018.
The Design team also includes a number of people with a middle management job. They are working on the elimination of their own job. This goes well because management has made clear that the intention is to keep everyone on board; it is not a cut operation. Eventually all people in middle management will get a new job as a Team-coach or Client-coach. 

Results
The article describes no results. It is probably too early for that.

Lessons learned

• You must be willing to invest time and resources that might deliver in the medium term;

• Involve all levels, disciplines and regions in the process from the outset;

• People need time to accept a transition, therefor organize a follow-up after they have been informed;

• Once the implementation process has started, the momentum should remain;

• Occasionally, look back to what has already been achieved. 

Reference

Coppin, Lisa, ‘In de ban van de eclips. Van gecentraliseerd en hiërarchisch aangestuurd naar lokaal, multidisciplinair en zelfsturend’ In: Flandres Synergy’s Member Magazine – Number 8 – 2016, Goede praktijken, pp. 6 – 10. The article is attached.

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