The paper presents findings from a longitudinal study investigating the impact of participatory workshops using the Innovation Guide on learning and innovation skills among employees and middle managers in municipal healthcare institutions. The study, conducted in municipalities in Norway and Sweden, employed engaged scholarship to involve stakeholders in the research process. Qualitative data from interviews and participatory observations were analyzed thematically. Results indicate that participation in co-creative workshops led to increased awareness among employees regarding their role in addressing workplace challenges and fostering a culture of collaboration and innovation. Both managers and employees developed innovation skills, facilitated by the systematic approach of the Innovation Guide. The tool contributed to a culture change and the establishment of a sustainable learning environment within healthcare organizations. This research underscores the importanceof participatory approaches in driving sustainable change and innovation within healthcare settings, emphasizing the role of tools like the Innovation Guide infacilitating collaboration and workplace learning