Thinking, Acting and Organizing Differently: The Ruwaard Experiment

Abstract

In Ruwaard, a neighborhood in the municipality of Oss, in the Netherlands, a dream for the future was expressed as “Ruwaard is a vital community where citizens experience a life of better, more positive health at lower cost”. In reaching that dream, which included better care integration and quality of care, better social services and better housing at lower costs, one key success factor was identified as citizens taking more responsibility in managing their own health. This in turn would be dependent on a new kind of collaboration among actors in finance for housing, social services and health care in Ruwaard—as well as the citizens as active participants and initiators of these changes. For this new kind of collaboration to happen, the Ruwaard ecosysytem of actors (citizens, care professionals, social service agency leaders and boards of directors) had to think, act and organize differently. As a design strategy, a citizen centered approach was chosen—one where citizens are part of creating their own solutions. In this approach, the questions ‘what matters to me, what can I do, what do I need’ are used by all actors to identify necessary changes in establishing a new integrated care ecosystem. Early results include making the total social services budget available to the community and holding key organizational actors accountable for social and health care outcomes in the community. Additionally, a case study indicates that self-measured well-being of citizens is increasing and on average costs for various social and health care services are lower than before.