‘You have to be healthy to be able to manage a work injury case.’ This statement by an injured citizen became a significant trigger of change for the Danish Board of Industrial Injuries. The agency, which assesses insurance claims made by citizens who have sustained an injury (physical or mental) at work, was a professionally run government organisation. It had a sharply formulated strategy, effective performance management systems, had digitised much of its internal and external processes and had implemented lean management, speeding up case flows and increasing case quality. However, the results were surprising when the agency, in collaboration with MindLab, conducted in-depth ethnographic field studies of just four citizens with a work injury, observing their meetings with state and local government officials and videotaping citizens at home telling their case stories from beginning to end. Some of the agency's efforts had the reverse of the intended effect: an on-site ‘travel team’ that could settle cases quickly was perceived by the citizens as confusing and made them feel uncomfortable. A temporary, token insurance payment to offset the often quite long case duration triggered frustration because citizens mistakenly thought it was the final insurance settlement. With the permission, the Board used the video footage to analyse and create better approaches to the specific problems they experienced, reorganising service processes and communications. It also used the video snippets to create an imperative for additional systemic change throughout the organisation, engaging both top executives and front-line staff in the process.

When civil servants learn about the citizen's experience, from the citizen's point of view, it is often a significant eye-opener (Bason, 2007; Bason et al, 2009; Bason, 2017). Even the most professional and service-minded organisations can have major blind spots, for the simple reason that they are not the people whom they serve. Placing citizens at the centre of the innovation process is to see one's efforts from the outside-in (Boyle et al, 2010). It is to recognise that citizens are experts in their own lives and nobody – nobody – else can claim that role. But it requires us to suspend our own judgement of people and how they experience the world, and allow ourselves to connect to their personal experience, seeing it for what it really is (Scharmer, 2007).