A case study of enabling integrated care through total workspace innovation in a large homecare organization
Authors: Elke Vandenbussche; Bart Roegiers; Inge Croes
Year: 2023

Care and welfare providers operate in a volatile, uncertain, complex and ambiguous world. Clients’ needs have become more diverse and complex and can no longer be addressed by solely one organization, much less by a single caregiver. Individualized interdisciplinary answers are expected and health- and welfare providers want to be able to deliver.  Familiehulp, a multiregional homecare organization providing home and social care in the comfort of the client’s own home, made the conscious choice to break down its unwieldly hierarchical organization in order to become more agile in this changing context. A well-considered story of trial and error has led to a new organizational structure: an innovative organization of work. 
The four-year journey started in 2015 with a kick-off meeting, moderated by a consultancy agency. Clients and their informal caregivers, a delegation of the trade union and employees, local staff members, team leaders and central management participated in the dialogue of mutual understanding of the need for change. 
A design team including participants from all layers of the organization, under the guidance of a central project team, started rethinking the organization chart and team structure. Bottom up approach focus groups were assembled to identify tasks and responsibilities that could be delegated to other functional levels. Next, expedition teams, including clients opinions by written inquiry, were to experiment on how to delegate responsibilities to layers deeper in the organization, as close as possible to the clients’ and employer’s needs. Throughout the process we worked with various experts in (shared) leadership and organizational and team development. 
Implementing this new structure impacted over 80.000 clients and 13.000 employees. In order to provide better service and care, the new organizational design is structured around the clients and their needs. Resulting in increased responsibility, more flexibility and higher employee involvement in the newly formed self-organizing teams. Monitoring consists of one central and 18 regional project management teams. 
This journey resulted in Familiehulp having a more agile responsiveness to external changes. Clearly identified and shared person-centered vision led to neighborhood operating teams, with extended collaborative networks. Employees closest to the client have actual impact in finding the best solution for their client by participating in multidisciplinary meetings with clients. Attributing ‘star-roles’ made additional responsibilities for distributing information within the teams visible. Management roles of middle management turned into coaching focusing on growth, talent development and reinforcement. Distributing digital tools such as smartphones among the employees was an important facilitating factor. 
  
Innovation is a continuous process and Familiehulp needs to keep investing in maintaining and evaluating the team structure and coaching our teams and leaders. Ongoing adjustments in supporting systems such as digital projects adapted to the needs of client and employee are needed as well. 
Our conclusion is that innovative organization of work, while not an easy journey, can provide an answer to today’s challenges in human talent management and fast changing client needs.