Purpose - The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge-management strategies have scaled-up learning and development in rural, remote and other resource-constrained Canadian delivery settings. Design/methodology/approach - Intervention design was realized through a one-time, collaborative, national capacity-building project. A project portfolio of 72 sub-projects, initiatives and strategic activities was used to improve access, enhance quality and create capacity for palliative and end-of-life care services. Evaluation was multifaceted, including participatory action research, variance analysis and impact analysis. This has been supplemented by post-intervention critical reflection and integration of relevant literature. Findings - The purposeful use of collaboration, innovation and knowledge-management strategies have been successfully used to support a rapid scaling-up of learning and development interventions. This has enabled enhanced and new pan-Canadian health delivery capacity implemented at the local service delivery catchment-level. Research limitations/implications - The intervention is bounded by a Canada-specific socio-cultural/political context. Design variables and antecedent conditions may not be present and/or readily replicated in other nation-state contexts. The findings suggest opportunities for future integrative and applied health services and policy research, including collaborative inquiry that weaves together concepts from adult learning, social science and industrial engineering. Practical implications - Scaling-up for new capacity is ideally approached as a holistic, multi-faceted process which considers the total assets within delivery systems, service catchments and communities as potentially being engaged and deployed. Originality/value - The Pallium Integrated Capacity-building Initiative offers model elements useful to others seeking theory-informed practices to rapidly and effectively scale-up learning and development efforts.
