The challenges facing health organizations rarely come with a clear map. Missions depend on partners, funding shifts, needs evolve and what worked last year may not work next year. That’s where we do our best work.
The cases below show what that looks like in practice. They include public health units planning their next chapter, hospitals redesigning services around patients, professional associations finding their place in a changing system and charities building the foundations for lasting impact. Each story is short: the challenge, what we did together, and what it produced. They represent a sample of the work we’ve done in service of clients over the years.
They are organized by our three service lines: Strategic Plans & Evaluation, Services & Systems Design, and Leadership & Learning Support. Whether you lead a health organization, a professional network or a foundation, you’ll find examples close to your own situation.
Every organization is different, but the pattern holds: when strategy, design, evaluation and leadership work together, organizations can heal by design.
See something close to your situation? Let’s talk about what’s possible for your organization.
Strategic Plans & Evaluation
Plans that connect vision and resources to action, with evaluation built in so leaders learn as they go.
Planning the next chapter after a pandemic
Peel Public Health · Health Organizations · 2021–2023
The challenge. After 20 months of pandemic response, Peel’s leadership needed to decide what to keep, what to drop and where to head next. They faced an exhausted workforce and a rapidly changing social, health, and systems context in which they needed to restore regular services, continue to address COVID and it’s consequences, and integrate the lessons learned from its emergency response into its regular programming.
What we did. Interviewed and surveyed leaders across the health unit, including the mass vaccination team, to capture lessons learned. Undertook an organization-wide after-action review, including facilitated debriefing sessions with staff across the institution. We built a foresight scan using the Three Horizons method across five trend areas, from mental health to climate. Facilitated a leadership visioning day and the strategy work that followed.
What it produced. A post-pandemic emergency strategy grounded in what staff said worked (peer support, fast decisions, creative problem-solving) and in service of the trends ahead, not only in the crisis behind them.
A five-year plan for a provincial professional association
Ontario Association of Public Health Dentistry (OAPHD) · Professions & Networks · 2025–2026
The challenge. Public oral health was shifting fast, with the new Canadian Dental Care Plan and changes coming to Ontario’s public health standards. OAPHD needed a clear role and value for its members.
What we did. Ran board and member consultations, a member survey and a SWOT analysis, three board strategy sessions and a member feedback session.
What it produced. A 2026–2030 strategic plan with a new vision, mission, values and a phased framework designed as a flexible guide rather than a fixed template.
Rebuilding foundations before growth
Ronald McDonald House Toronto · Foundations & Charities · 2025-2026
The challenge. A charity serving families of seriously ill children needed stability and trust after a period of leadership change while connecting its local services to a global framework for evaluation. It needed to link its strategic planning with an evaluation strategy while engaging a workforce that had experienced enormous change in a short period of time.
What we did. We engaged the leadership team and entire Ronald McDonald House Toronto community that included familys, the board, and partners. We surveyed staff and senior leaders, analyzed themes, and worked with the board, executive and senior team through drafts and a board workshop. We helped them connect the global evaluation framework proposed by the international partners and made it local and fit to serve the context of Toronto’s house.
What it produced. A three-year capacity-building strategy (2026–2028) around leadership and governance, people and culture, and operations, with a matching set of evaluation metrics and KPIs.
Turning program data into evidence for policy
TakingITGlobal – Connected North · Foundations & Charities · 2019–2026
The challenge. Connected North brings live virtual learning to schools in remote and northern communities. It needed to show funders and governments what difference it makes. Connected North was seeking to understand the impact it was having in the communities it served, and frame the work they were doing within the context of health.
What we did. We engaged their team, which included many teachers and staff working in Canada’s North, to develop a model of wellbeing that was grounded in their values and the many remote and indigenous communities they serve. We also reviewed student and teacher survey data collected from programs, grantee data and the research literature across several evaluation cycles since 2019. This linked the program model to the outcomes it has meant to produce.
What it produced. We created a model of wellbeing grounded in the values and experience of their communities and the evidence from the literature. An evidence summary, a strategy presentation and a 2025 policy brief. The brief highlights the program’s reported 96.4% graduation rate among its Digital Inclusion Grantees and sets out funding and governance recommendations.
Services & Systems Design
Bringing people, ideas and processes together to design services and systems that improve health.
Designing quit-smoking support into cancer care
CAMH, with Ontario’s regional cancer centres · Health Organizations · 2025–present
The challenge. Quitting smoking improves cancer treatment outcomes, but support is uneven across Ontario’s 14 regional cancer centres. An expert consensus study had named promising strategies; the question was how to make them work in busy clinics.
What we did. Mapped service workflows for the strategies with the strongest consensus, such as free nicotine replacement onsite or by mail. Built patient journey maps for different cancer types and stages, and pinpointed the best moments in care to raise quitting. Developed low-fidelity prototypes, and explored whether an AI motivational-interviewing tool could support patients and staff.
What it produces. Practical service designs that fit real clinic constraints like time, space and staffing, instead of a guideline that sits on a shelf. It connects AI to health providers, patients and health system leaders seeking to provide support for professionals and patients alike in the oncology context.
Taking a hospital program into the community
Holland Bloorview Kids Rehabilitation Hospital · Health Organizations · 2019–2020
The challenge. Holland Bloorview wanted to share successful programs with community partners through a “Program in a Box” model, without losing what made them work.
What we did. Coached the team through principles-focused design: shared values, then minimum specifications that every site must keep, leaving the rest open to local adaptation. Ran design workshops on partner selection, delivery and support, and drafted an evaluation framework.
What it produced. Clear principles, partner-screening criteria and program artifacts that let each community adapt the program while keeping children safe and the model intact.
Organizing a national system of systems
Rick Hansen Institute / Praxis Spinal Cord Institute · Professions & Networks · 2019–2022
The challenge. Spinal cord injury care in Canada spans 13 jurisdictions, many disciplines and informal networks. A national strategy needed buy-in from all of them.
What we did. Led national consultations and mapped the landscape across prevention, care, data, workforce, research and advocacy, led by the Praxis Institute as a convenor. The result was a series of strategic guidance documents and consultations that were manifest in the Being Bold strategy and the Learning Circles national campaign to promote learning and innovation in spinal cord research, practice, and advocacy across Canada. Wrote the consultation report and supported strategy development and implementation, through to an animated strategy launch for the 2021 national summit.
What it produced. A roadmap for a national health, care and wellness strategy, with principles, co-creation tactics and a sample evaluation design.
Redesigning a shared home for the philanthropic sector
Foundation House · Foundations & Charities · 2023
The challenge. Since 2016, Foundation House in Toronto has been a shared workspace and convening hub for leading philanthropic and nonprofit organizations. After the pandemic, a once-busy space felt empty: most tenants came in fewer than three days a week. With a lease renewal ahead, the three anchor tenants needed to rethink what the space was for.
What we did. Started with a site visit, leadership consultations and a scan of research on post-pandemic workplaces. Surveyed tenants and staff about how they use the space and what they value. Led five co-design workshops (four in person, one virtual), working openly in a shared online whiteboard so the community could see ideas take shape.
What it produced. Eight design themes, from intentional events to skills development and opening the space to the wider community. These became three future models (Open, Professional and Vibrant) for leadership to choose from and build on. The results went back to the whole community at a lunch-and-learn, so tenants saw their input reflected in the options.
Leadership & Learning Support
Advisory, coaching, training, facilitation and curriculum for leaders working in complex settings.
Making sense of AI’s impact on work and health
Institute for Work & Health (Dr. Arif Jetha) · Professions & Networks · 2022
The challenge. A research partnership funded by the WSIB was exploring how AI could change workplace injury prevention and recovery in Ontario. About 30 partners from different organizations brought very different levels of AI knowledge.
What we did. Designed and facilitated a futures session: a shared orientation to AI, then breakout groups by sector (such as manufacturing) to work through risks, opportunities and scenarios from the worker’s point of view. Captured and synthesized each group’s thinking in real time.
What it produced. A common language across partners, sector-by-sector insight on AI’s implications and early direction for the research program. The same approach helps any health leadership team plan for AI before it arrives on their doorstep.
A systems-thinking course for young social innovators
Studio Y (MaRS Discovery District) · Foundations & Charities · 2014–2016
The challenge. Studio Y’s youth innovation fellowship needed a way to help emerging leaders understand how human systems change, and how to act on them. MaRS developed Studio Y as a means to support innovative change-makers and future leaders in service of their mission to help innovators build a better world.
What we did. Designed and taught the systems thinking module across four cohorts, mixing classroom discussion, workshops and lab work on fellows’ own projects, alongside design and entrepreneurial thinking. The multi-week course provided a foundation for the program and connected its vision to the practical and strategic needs of working within systems to promote social and health innovation.
What it produced. A tested curriculum built on three pillars: leadership development, problem-solving and systems change. This 8 week course was repeated over multiple cohorts and evaluated to demonstrate an ability to connect fellow’s understanding of systems to social innovation and impact.
Training and coaching changemakers
CatalystX · Foundations & Charities · 2014–2016
The challenge. CatalystX’s CoPilot program supported people leading social change and needed a curriculum and evidence of what participants gained.
What we did. Co-developed and delivered a two-weekend training on reflective practice, systems thinking, design and evaluation, the psychology of change, leadership and scaling. The course was part of an accelerator that supported young entrepreneurs and social innovators to develop and realize projects aimed at promoting health and wellbeing in their communities across Canada. We also evaluated the program and helped tell its story.
What it produced. A practical, cohort-based curriculum and evaluation data to guide the next round.
Rebuilding a graduate program in Design for Health
OCAD University · Professions & Networks · ongoing
The challenge. The health system needs leaders who can design in complexity, and graduate training has to keep pace.
What we did. Cense principal Cameron Norman teaches at OCAD as Adjunct Professor in Strategic Foresight & Innovation and Design for Health, and is leading, with faculty colleagues, the rebuild of the Design for Health curriculum, drawing on complexity leadership and design theory.
What it produced. A restructured program for students starting in Fall 2027, with new credit structures, a revised major research project and courses shared across design master’s programs.
Bringing design into the evaluation profession
American Evaluation Association · Professions & Networks · 2017–2020
The challenge. Evaluators wanted hands-on ways to apply design thinking to their work.
What we did. Created and ran the Design Loft training program (a conference-within-a-conference) at AEA’s annual conference: hourly drop-in workshops, each teaching one tool, such as user personas or “a day in the life” mapping. This conference was meant to provide evaluation professionals with the skills to use and adapt design-driven strategies to better connect their work in evaluation with the services and systems they work in.
What it produced. Four years of practical design training for evaluators from across the field, which led to additional training, strategic changes and adaptations at AEA, and spawned The Design Loft training program that is ongoing and available through Substack.
Coaching an academic centre in principles-focused evaluation
CCEDNet and the Waterloo Institute for Social Innovation and Resilience (WISIR) · Professions & Networks · 2021–2023
The challenge. CCEDNet and WISIR at the University of Waterloo were evaluating the second phase of the federal Investment Readiness Program, which helps social purpose organizations access social finance. The work involved researchers, graduate interns and many community partners, and their goal of shared principles was hard to measure with conventional evaluation.
What we did. Designed and delivered a practical learning program in principles-focused evaluation for the WISIR team, from systems thinking and surfacing values to turning principles into action and measuring them. Coached the team on real cases from the program as the work unfolded, consulted on evaluation design and helped draft a survey testing the program’s principles with partners. Co-presented the approach with WISIR’s co-director at a federal learning event.
What it produced. A research team able to design and run principles-focused evaluations on its own, a reusable curriculum, and evaluation tools built around the principles the program was meant to live by.