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

Artikel i vetenskaplig tidskrift, 2025

Purpose-The purpose of this study was to explore important elements involved in interorganizationallearning (IOL) in the complex context of integrated health care. Design/methodology/approach-The study applied concept-driven content analysis of qualitative datacollected from documents, protocols, reports, reflection circles and interviews related to an improvementinitiative in Norwegian integrated health care for elderly and fragile patients. Findings-The analysis supports the applicability of Engestr & ouml;m's activity system model to betterunderstand the local contexts of IOL in integrated health care. However, the study also identified anessential additional contextual element in the case under study: an organizational network structurebinding all involved parties together. This structure was crucial for facilitating the IOL process,indicating potential for further development of Engestr & ouml;m's model to address the complexities ofintegrated 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 distinctelement, organized as a network structure that connects all stakeholders. Implications for leaders andpolicymakers 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 onIOL in integrated health care.