Thanks for connecting with us at ASDP 2026.

Here’s some backstory about our project in The Kimberley, extending from Cassie’s presentation and what’s on our Projects page. We’re proud of what we achieved and hope Xstitch becomes a pathway for doctors to help improve systems. Cassie is proof that you don’t need to be a senior consultant to lead system improvement! 

If you want to know what it’s like working at Xstitch, there are FAQs at the bottom of this page.

The Kimberley project

We prepared for our conversations with remote area communities by writing a stakeholder engagement methodology. We had a foundational methodology from a previous project with the Somalian refugee community, but it needed to be adapted. We used methods from anthropology, sociology and participatory action research to construct our approach. The aim was to hear existing community knowledge, rather than answers to pre-written questions which would inevitably be loaded with assumptions.

Our hallmark methodology is called the Problem and Objective Tree. Versions are readily available online. It’s simply a visual tool, but the magic happens in the communication strategies around it. That’s what we focus on. When adapted appropriately, it crosses cultural boundaries. We recently used this methodology to write the global strategic plan for the International Society of Physical Medicine and Rehabilitation, where the stakeholders comprised representatives from the WHO world regions. The concept of a tree needed no cultural translation.

In the Kimberley project, Problem and Objective Trees were used to collect 119 conversation data points. They were coded into themes, from which 6 domains emerged. Here they are, with an example for each domain. 

ASDP 2026 Annual Meeting

Our role became clear once we surfaced the community knowledge, strengths and needs. That’s why it’s difficult to fit our work into traditional project structures… because we don’t know the detail of what we’re doing until the community tells us.

It turns out we needed to create the “glue” to bring the community-led child development program together. We wrote four interconnected documents that facilitate program adaptation while staying true to the community’s needs and the evidence base. The documents were a governance framework, program model, adaptation capture system and impact measurement framework.

There were some auxiliary documents as well. We enjoyed creating the Postponement Planning System, for when community sessions need to be cancelled (eg due to staff shortage or weather events). Since we couldn’t find relevant research in the Health sector, we drew from processes in Supply Chain Logistics.

Xstitch sits between systems and creates collaborative processes. We build the glue between siloed services. As health services become more specialised, we think it’s vital for doctors to not just understand this, but also be part of the solution.

There is an economic analysis of the impact of funding the “glue” here.

Working at Xstitch Health

Most of this website is targeted at community agencies, not doctors. With that in mind, here are the questions we are asked when doctors reach out to us:

  • No, because you will be paid! The only volunteers are our board of directors.

  • No, because we only do system-level work. This is a new type of job for a doctor, and we are proud to offer it.

  • Xstitch has learning packages about system theory and complex decision making. If you’ve been accepted onto a project, these are done in your paid hours. You will also have a mentor that has been in your situation.

    Systems thinking isn’t taught to doctors. At Xstitch, you learn it, then apply it immediately.

  • We’re a small, supportive team. Projects can vary from weeks to months. You typically work a few hours per week when it suits you, and attend meetings where needed. If you travel for projects, all expenses are covered by Xstitch (eg flights, accommodation, meals). If you present our work at conferences, you are paid for the preparation time and, depending on the conference, Xstitch covers some conference expenses.

  • We are currently testing this!

Xstitch is about curiosity, purpose and fun. If that resonates, we would love to hear from you.