Buurtzorg: scaling up an organization with hundreds of self-managing teams but no middle managers

In this contribution to the Organization Zoo series, we examine Buurtzorg, a highly successful Dutch home care organization with over 14 thousand employees that operates without any supervisors or middle management. Given its size, it is a rare example of a self-managing organization that has radically decentralized decision-making to empower autonomous teams to operate highly independently while growing to thousands of employees. Buurtzorg’s case sheds light on the role of supportive structures, including purpose-built information and communication technology and a small team of internal coaches, that the firm uses to scale up a self-managing organization of over 900 independent teams.