PurposeThe 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).Design/methodology/approachThis 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.FindingsThe 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).Originality/valueThis 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.