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On a pleasant autumn evening in 2008, 15 people got together in a hotel meeting room in the Dutch seaside resort of Bergen. All of them had some involvement in setting up a new Elective Care Center (ECC) as part of a nearby hospital. Most of the participants in the meeting did not know any of the others. They had not received an agenda, just a one-page invitation with a photo of a girl blowing bubbles and the request to join an important workshop in the design of the new center. No preparation was necessary. The people trickled in, had some coffee, and stood about somewhat uneasily. Some talked about the nice weather or the trouble they had in finding the hotel. Among the participants were a surgeon, a general practitioner, a nurse, a health insurance representative, and even a patient. Although the surgeon and the general practitioner had never met, they knew each other by name. The surgeon decided to take this opportunity to complain about some of the wrong referrals he had received from the general practitioner. The general practitioner responded with his complaints about the delays in receiving the results of procedures. The mood was set for a traditional round of exchanging viewpoints without making much progress towards the shared goal of a new center.