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The purpose of this study is to identify important strategies and practices supporting inter-organizational learning (IOL) in integrated care. The two research questions ask how organizational network architectures can help involved organizations overcome the barriers of IOL in integrated care (RQ1) and what design recommendations can strengthen the processes of IOL in integrated care (RQ2).

This study applies a qualitative design to analyze an improvement initiative in a regional, integrated care service for elderly patients with multiple illnesses in Norway. An inductive thematic analysis for the triangulating of qualitative data from different sources was applied. Patterns within the data were organized into themes, categories and subcategories. No software was applied.

The identified characteristics of the organizational network architectures supporting IOL in integrated care in the case under study were: equality of the involved parties, shared goals, recognition of expertise and the abilities to coordinate, design IOL processes and make joint decisions (RQ1). The categories of practices supporting the process of IOL were: insight into complex realities, contradictions, iteration, motivation and prototypes (RQ2).

This study offers much-needed insight into a successful approach for IOL in integrated care. The results offer strategies to be considered when building organizational networks for the improvement of integrated care and relevant practices useful when designing IOL processes in such care services. We believe such knowledge has important implications for policymakers, frontline personnel, education, research and leaders.

There is growing recognition that transformation of healthcare systems towards health and well-being systems requires a continuous learning process. This explorative study aims to gain insight into the experiences with and investment in these learning processes within regional partnerships for health and in what they need to enhance their learning capacity to use the learning for transformation.

17 interviews were held with programme managers, data scientists, trusted advisors and a citizen representative, all involved in the learning process on a regional level in ten Dutch regional partnerships. The interviews were inductively and thematically analysed, focusing on the experiences and perceptions underlying the learning processes.

Regional partnerships invest in learning processes by organizing interactions between different groups of stakeholders and by reflecting on specific themes or on a region-wide level. Difficulty was found in region-wide reflection and in enhancing the learning capacity within the partnerships. Further enhancing the learning capacity required: (1) Investment in (the use of) expertise for translating learning outcomes into concrete action; (2) Leadership for change, underpinned by a shared sense of urgency to learn for transformation and (3) A facilitative environment for change which is both based on facilitative system structures and a basis of trust and commitment to learn and adapt.

The study highlighted the difficulty of learning on a region-wide level and the struggle to apply this learning for transformation. It provides insights into how learning processes and learning capacity can be further improved.

Due to the rapid ageing of the continent's population, a significant surge in long-term care expenses for the elderly is expected across Europe in the coming years. Could a potential solution to this challenge involve the increased informal care provided by adult children? In this context, we examined a general view or moral duty of European citizens regarding whether adult children should assume responsibility for providing long-term care to the elderly.

Our multilevel analysis draws on individual-level data from the 2017 European Value Study and country-level data from various European sources encompassing participants from 21 member countries of the European Union.

The findings reveal that in nations where public long-term care services are sufficiently available and of superior quality, there is a negative sentiment towards the notion that adult children should bear the responsibility for elderly care. In total, 71% of the country-level variance in our dependent variable was explained by the availability and quality of formal long-term care in a country. Furthermore, various individual-level attributes contribute to shaping attitudes towards care-giving responsibility. We observed that women, middle-aged individuals, those without religious affiliations, those with modern gender role attitudes and non-immigrants tended to hold unfavourable attitudes towards the responsibility of adult children in long-term care provision.

There are relatively many studies on the general attitude of the population towards filial obligation. However, so far there have been very few studies available that examine the population's attitude towards the obligation of adult children to commit to their parents' long-term care. Our research explains the variation of the phenomenon in Europe with both country-level and individual-level factors.

We identify lessons from a project sponsored by a large charitable trust, which sought to build capability for end-of-life (EOL) care in Hong Kong through interdisciplinary and multi-agency collaboration.

An in-depth case study drawing on 21 in-depth interviews with diverse stakeholders was conducted. Lyman et al.’s (2018) model of organisational learning (OL) in healthcare settings was applied to analyse the relative emphasis on particular contextual factors and mechanisms, and to identify outcomes perceived to have been achieved.

Infrastructure such as materials for assessment and education received the most emphasis among the contextual factors and deliberate learning such as training sessions received the greatest attention among the mechanisms. While perceptions indicated that desired outcomes were being achieved in terms of social impact, there were relatively few mentions of “soft” factors such as enhanced motivation, leadership or OL skills among staff.

This study extends the literature on how to create valuable social impact through OL. While prior studies have examined social impact in terms of solutions for social and environmental problems, ours is one of the few that examines how improvements are made to organisations’ capability to deliver such impacts in the context of healthcare.

This paper aims to extend insights about the relationship between inter-organizational collaboration and approaches to control from the perspective of decision-makers. We investigate the relationship between approaches to control and intended forms of integration between actors responsible for solving the complex problem of integrated person-centered care for elderly with diverse and significant needs.

The empirical study is based on a content analysis of contractual agreements. We have analyzed a total of 118 collaboration agreements and associative documents between all Swedish regions and municipalities.

The study shows that intended integration is subject to remarkable variation in intended forms of inter-organizational collaboration in this Swedish case. The paper illustrates that decision-makers’ intentions with proposed collaboration in each given context are important for the chosen approach to control. Regardless of intended forms of integration, our study suggests that an imminent soft approach to control is expressed alongside limited signs of hard control. Various forms of intended integration can be managed by the two approaches simultaneously insofar as the agreements appear to have a two-sided purpose.

Our paper proposes an empirically driven taxonomy of intended forms of integration initiatives. The taxonomy provides resources for studies about how collaboration can be managed when it is stipulated by national legislation but local self-governance gives actors considerable freedom to decide on how to organize and manage services. By presenting the taxonomy and relating this to approaches of control, our iterative study builds on and adds to a recent stream of research arguing that the relationship between collaboration and approaches to control may by fuzzier and more complex than originally thought.

The Purpose of the study was to investigate the construct validity and internal consistency of the LaMI among staff in the context of elderly care in Sweden.

Questionnaire data from a longitudinal study of staff working in elderly care were used. Data were collected using the Leadership and Management Inventory. First data collection was for explorative factor analysis (n = 1,149), and the second collection, one year later, was for confirmatory factor analysis (n = 1,061).

The explorative factor analysis resulted in a two-factor solution that explained 70.2% of the total variance. Different models were tested in the confirmatory factor analysis. The final model, a two-factor solution where three items were omitted, showed acceptable results.

The instrument measures both leadership and management performance and can be used to continually measure managers’ performances as perceived by staff to identify areas for development.

Based on the comprehensive definition of accounting of Carnegie et al. (2021a, 2021b), this study examines how visual imagery can expand and enhance accountability to stakeholders and create room for more human-centric accounts. This study aims to understand how this use can elucidate and prompt interpretations of rhetorical features aimed at envisioning legitimacy and being perceived as accountable.

Following a methodological interpretative approach, this paper draws on a qualitative case study based on a Portuguese charity, the Santa Casa da Misericordia do Porto, from 2019 to 2021, including the COVID-19 crisis period, analysing visual rhetoric in annual and sustainability reports.

The study illuminates how the visual images interact and evoke shared cultural understandings, shaping meanings that can symbolically foster organisational legitimacy and envisions accountability. These symbolic and emotive elements capture and make visible social impacts and reflect broader societal concerns.

The study of visual images within the accounting context can enrich the understanding of accounting as a technical, social and moral practice, while expanding the scope of accountability and promoting a more human-centred approach to accounting. It also adds to the literature on the persuasiveness and rhetoric of accounting and reporting visualisations and on charities’ accountability in crisis period.

To facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services post-discharge.

Hospitalised patients undergo the Blaylock risk assessment screening score (BRASS), a screening tool identifying those at risk of complex discharge.

Pre-pandemic, patients with a medium-to-high risk of complex discharge were predominantly discharged to their residence or long-term care facilities. During the pandemic, coinciding with an overall reduction in hospitalisation rates, there was a decrease in patients being discharged to their residence.

The analysis of discharges, with the classification of patients into risk groups, revealed a coherence between the BRASS score and the characteristics of the studied sample. This tool aids physicians in decision-making by identifying the need for a planned discharge in a systematic and organised manner, preventing the loss of crucial information.

The purpose of this paper is to describe how first-line managers (FLMs) in home care (HC) reason about the opportunities and obstacles to lead the work according to the individual’s needs and goals.

In this participatory appreciative action reflection project, eight managers within one Swedish municipality were interviewed. The data were analysed using a thematic analysis.

The results showed a polarization between two different systems that FLMs struggle to balance when attempting to lead HC that adapts to the needs and goals of individuals. One system was represented by the possibilities of a humane system, with human capital in the form of the individual, older persons and the co-workers in HC. The second system was represented by obstacles in the form of the economic needs of the organization in which the individual receiving HC often felt forgotten. In this system, the organization’s needs and goals governed, with FLMs needing to adapt to the cost-effectiveness principle and keep a balanced budget. The managers had to balance an ethical conflict of values between the human value and needs-solidarity principles, with that of the cost-effectiveness principle.

The FLMs lack the opportunity to lead HC according to the needs and goals of the individuals receiving HC. There is a need for consensus and a value-based leadership model based on ethical principles such as the principles of human value and needs-solidarity to lead the HC according to the individual’s needs and goals.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.