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The following theoretical challenges concerning learning in organizations and at work are examined in the study. First, organizational learning is not only the formation of collective routines; it is also tool‐creation and implementation. Second, tools evolve as they are implemented. Third, tools become powerful when they become an interconnected instrumentality and constellations. Tool‐creation and implementation are examined when a new set of tools is being appropriated for collaboration between primary and secondary health care. Boundary crossings in the interaction of the multiple providers are focused as an essential context of tool‐creation during implementation. The findings concerning the tool‐creation during implementation process include the productivity of the resistance, the importance of turning points, the formation of the new instrumentality, the discovery of gaps, and the necessity of stabilization and maintenance in organizational learning. Finally, conclusions about learning in the creation of work practice will be proposed.

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