Understanding inter organizational learning for improvement in integrated health care – a Norwegian case study about collaboration across borders

Purpose The purpose of this study was to explore important elements involved in interorganizational learning (IOL) in the complex context of integrated health care. Design/methodology/approach The study applied concept-driven content analysis of qualitative data collected from documents, protocols, reports, reflection circles and interviews related to an improvement initiative in Norwegian integrated health care for elderly and fragile patients. Findings The analysis supports the applicability of Engeström’s activity system model to better understand the local contexts of IOL in integrated health care. However, the study also identified an essential additional contextual element in the case under study: an organizational network structure binding all involved parties together. This structure was crucial for facilitating the IOL process, indicating potential for further development of Engeström’s model to address the complexities of integrated health care. Originality/value This study tested and extended a long-standing model – the human activity system – within the context of integrated health care. The authors propose introducing leadership as a distinct element, organized as a network structure that connects all stakeholders. Implications for leaders and policymakers include the importance of developing network structures and conducting contextual analysis before designing IOL processes in integrated health care. The study opens new avenues for research on IOL in integrated health care.