Dutch homecare provider improves quality, productivity and employee satisfaction

The Client

  • A large homecare provider in the Netherlands
  • Care is provided for essential personal care and clinical tasks – Assistance with tasks such as meal preparation, companionship and shopping is provided by other organisations, as is usual in the Netherlands
  • Zero-hour contracts are prohibited in the Netherlands, so guaranteed hours contracts are used
  • A large number of contract types were used for the varying number of hours required by the carers
  • Carers are paid for client contact time and travelling time only


  • Perceived shortage of staff and difficulty coping with workload
  • Staff were dissatisfied with work patterns
    • Uneven distribution of workload, fragmented shift patterns
    • Some shifts were too short, while others were too long and fragmented
    • Poor work/life balance –  Not many free days for carers
  • Decentralised planning was time consuming and inefficient. Quality of planning was inconsistent between teams. Planning was generally basic and not focused on quality or efficiency

Approach and findings

  • Starting in a pilot area with 125 workers, Strategic Optimisation was performed with R² used to model alternative scenarios and ways of working – A collaborative approach was used to involve all levels of the organisation as well as clients and works council in the review and decision-making process to develop a solution accepted by all
  • Integrated teams were in use but were operating inefficiently – Scenarios were modelled to demonstrate the benefit of changing mix of skills and share of responsibilities within teams
  • Team sizes and boundaries were limiting efficiency of routes and productivity – Modelling showed that merging some teams had a significant impact on productivity and travelling
  • Care plans had been created based on time-task and organisational habit – Large portion of visits had fixed or very small time-windows and had negative impact on productivity. Scenarios were modelled to demonstrate the benefit of widening some visits’ time-windows

Changes made

  • Team areas redefined. Some teams/regions merged
  • Skill levels and share of responsibilities in integrated teams was adjusted
  • Some fixed and very narrow visit time-windows were widened by 30 minutes
  • Standardised 5, 6 and 8 hour work shifts introduced and matched to demand

Quantifiable benefits

  • 25% fewer staff needed each day: Productivity increased and unpopular shift patterns eliminated
  • Travelling between visits (time as well as well as distance) reduced by 45%
  • Travelling to/from home reduced by 25%
  • Time spent on planning reduced by 85%

Non-quantifiable benefits

  • Improved staff satisfaction: Fairer conditions for workers and better work-life balance
  • Improved quality and stability
  • Staff, works council and clients supported the changes
  • Easier to handle absences as there are 25% staff free each day