Networks of autonomous teams

A case study in adaptive organisation design

“Bureaucracy expands the freedom of those on top by giving them the power to restrict the freedom of those beneath.” — Robert Jackall

You may be asking by now, what exactly does a post-bureaucratic organisation look like?

Let’s look under the hood of one: Buurtzorg

About Buurtzorg

Buurtzorg provides home nursing and personal care: helping clients with preparation and administration of medicines, injecting insulin, taking care of wounds, giving injections, treating pain, or providing palliative care in the last phase of life, for example.


In an organisation of over 10,000 employees, there are no managers. None. Nada. Zero. Zilch. There is no management hierarchy, no bureaucracy. Senior Management consists of just two directors. Two!

This is possible because the organisation is structured as a network of autonomous teams. The following animation by Corporate Rebels explains it wonderfully.

The two key concepts are autonomous teams and networks. These are the core components of a complex adaptive system.

Let’s briefly dissect the Buurtzorg model.

Autonomous teams

A Buurtzorg motto is “Leidinggeven aan professionals? Niet doen!”, which translates to “How do you manage professionals? You don’t!”1

The nursing teams operate with maximal autonomy. They are responsible for finding clients, renting office space, hiring and firing team members, managing budget, scheduling and driving their own constant improvement. These functions are executed part-time by the nurses in each team.2

In order to cultivate self-governance, Buurtzorg teaches employees how to be their own managers. Every employee is taught group decision-making, active listening, conflict resolution, and peer-to-peer coaching.3 The functions of a traditional manager are shared by the team.

By removing the requirement for managers, managerialism — the control of decision-making power by an elite faction — can’t take root.4 Knowledge of how to run the organisation does not become the exclusive possession of an MBA-wielding management cabal. The nurses do not have to defer to, or pledge fealty to, any bosses.


There is no pyramid at Buurtzorg. The org structure is a network.

The teams communicate with each other and head-office support staff via Buurtzorg Web, the organisation’s intranet. On it, they share knowledge, compare performance, and create alignment. If someone needs help with a particular issue they simply reach out to the network.

There is also some shared admin and IT services for the group, as well as a group of coaches to help sort out problems.

It’s a very effective organisation design, as the results prove:

  • High client satisfaction

  • Low absenteeism

  • Low turnover

  • Minuscule overheads

  • Faster patient cure

Why can’t more organisations be structured like this?

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Learn more

I will be talking a lot more about adaptive organisation design in future transmissions.

Image Credit

Social Media ants image by Monster Pong


Monsen, Karen & Blok, Jos. (2013). Buurtzorg: Nurse-Led Community Care. Creat Nurs. 19. 122-7. 10.1891/1078-4535.19.3.122.


Hamel, Gary, and Michele Zanini. 2020. Humanocracy: creating organizations as amazing as the people inside them. (xi-xii)




There are several definitions of managerialism. I am referring here to Locke’s — “what occurs when a special group, called management, ensconces itself systemically in an organization and deprives owners and employees of their decision-making power (including the distribution of emolument), and justifies that takeover on the grounds of the managing group's education and exclusive possession of the codified bodies of knowledge and know-how necessary to the efficient running of the organization."

Locke, R.R. (1996). The Collapse of the American Management Mystique. Oxford: Oxford University