Keeping people healthy is one of the biggest challenges for all communities and countries. Finland started a promising approach to make people healthy and happy at the same time. This disrupting formula may be a cure for high costs.

Like in many other countries, Finland’s health services are built upon two pillars: the basic medical care is part of public services and private options are further available. Almost all health care services have traditionally been organized in a hierarchical way, with little variation between different organizations. Two health care organizations count on agility and celebrate a successful launch in their field: the private health care company Heltti and the city of Järvenpää’s home care.

Private health care on new paths

Heltti was founded five years ago in the conservative and quite homogeneous field of health services. CEO Timo Lappi brought something new to the market. He organized his health services as agilely as a software business. He dived into new models of organizations and explored the problems of traditional private health care from a customer perspective. Heltti wanted to offer a new solution to the needs of their customers. This required quick decision-making without hierarchies. Heltti’s own shaped »ball pool organization,« inspired by Spotify, Holacracy and Buurtzorg, was born. »An important part of our DNA is our decision-making model: we have no superiors or masters. Everyone makes decisions according to our consultation process,« says Lappi.

Focus on the patient

At the heart of all activities, Heltti has customer teams consisting of medical staff, doctors, therapists and sales people. Each team works independently in its territory. The structure is expanding in a cellular way. As the customer base grows, every team is split into two even parts, enabling efficient scaling. An important part of the organization is also a balanced partnership of equals. Employees work in open spaces; doctors skip status symbols like their well-known white coats. All customers are faced with informal reception.

Clear benefits of a new kind of organization

The new »ball pool organization« was started more than a year ago and benefits are clearly showing. The new organizational structure is very helpful in recruiting new employees. Innovative operating models are a real unique selling proposition, especially agile customer organizations are attracted by these services. Furthermore, the new structure is a real time saver. Meetings have decreased since decision-making and responsiveness turned agile. In the future, Heltti anticipates with reduced wage costs due to the design of the organization. As the structure expands, administration and support functions will not grow in the same proportion.

On the other hand, new challenges in organizing have emerged. Without hierarchy, a new set of self-management skills is required. The personnel and organization need continuous coaching to succeed. Likewise, it is necessary to repeat the principles of action so as not to forget what is being done and why. The most important realization so far: Leadership has not diminished, but its role has changed.

Järvenpää adapts successful care model

Buurtzorg is a synonym for a very lean and agile Dutch home care model. The pioneering healthcare organization shows the highest satisfaction rates among their clients combined with cost savings up to 40 percent. Teams of 12 people work self-organized and autonomously for 40 to 50 clients in different care settings. The project has been running very successfully for more than ten years now. The city of Järvenpää was looking for more agile alternatives to home care services when it was introduced to Buurtzorg in 2017.

Piloting Buurtzorg

2018 Järvenpää started with an adaption of the Buurtzorg model. During the pilot phase, the public organization found many obstacles. The boundary conditions by law and further responsibilities had to be taken into account; the role of leadership had to be shifted to a coaching approach. According to Päivi Autere, HR director, the most important thing was to make supervisors understand what self-directedness meant, why the reform was implemented and what the new managers role was. »Managers need to find their own internal motivation for coaching, engaging and motivating the staff . Like supervisors, their new role is to help in solving problems, set ambitious goals or settle conflicts,« says Autere.

Gain for all parties involved

The most outstanding benefits of the new structure are economic advantages and increased well-being among staff. Sick leave has dropped by over 20 percent. Cutting costs leads to significant savings. In the future, the number of supervisors will be reduced since their preparatory role enables them to lead more teams. Overall, the first step of the project is a huge success. Caregivers are empowered to develop solutions and make decisions close to their clients needs, which leads to a greater well-being on both sides. With the structural reform of basic services in central Uusimaa province in January 2019, Järvenpää home care was integrated into the services of the Keusote’s social and healthcare coalition, where Päivi Autere also joined as HR director.

Image: phipatbig, source: Shutterstock; Suvi Sievilä