In health and care service processes the coordination between different caregivers is one of the crucial challenges. This paper presents The patient journey project  as a practical application of a pragmatist pattern of inquiry (Dewey, 1938) and as fruitful way to work with/achieve transformative design. Situations of lived experience and moments of reflections perform as a carrier of knowledge and development. The paper argues that the design tools and mindset used in this project are of great importance in the ongoing transformation towards the patients focus in a Swedish public health care organization.