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Buurtzorg: Scaling Up an Organization With Hundreds of Self-Managing Teams

An academic case study of how Buurtzorg scaled a self-managing organization using supportive structures, internal coaches, and purpose-built information systems.

Source: Journal of Organization DesignAdded June 12, 2026Published 2025
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Why it matters

The case shows the small back office, coaching capacity, shared purpose, and information systems that make team autonomy possible at scale.

Best for

Operators and researchers examining which support functions remain necessary when an organization removes conventional middle-management layers.

This open-access 2025 article analyzes Buurtzorg's model of hundreds of autonomous nursing teams without conventional middle managers. Its evidence includes interviews, observation, internal documents, and multiple research waves led in part by coauthor Sharda Nandram.

Use it to study the infrastructure around self-management rather than as a template for removing managers. The case is a Dutch home-care organization with a specific professional and regulatory setting; transferring the design to another industry still requires attention to local work, risk, and accountability.

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