created by the BC Patient Safety & Quality Council
Activities for Transforming Teams
and Igniting Change
ATTIC is a collection of tools, games, and activities to inspire innovation, teamwork and engagement in health care settings.

Step Back

Often, in our work and in our lives, we don’t have the opportunity to stop and truly reflect on what we are doing and what we could change. This exercise provides an opportunity to reflect on the shifts that can happen in adaptive systems, and the importance of pausing, taking a step back, and reflecting on what we are doing and how we could do it better.

Download Activity Worksheet

  • 15 minutes
  • Groups of 6-8
  • 5-6 differently-sized balls per group

  • Source: Unknown

What to do

  1. Have participants stand in a closed circle. (Note: If the group is very large, it may be necessary to split people up into smaller groups.) Assign a facilitator for each group.
  2. Facilitators start by throwing the ball to someone in the circle and saying their name as the ball is thrown.
  3. Have participants continue catching and throwing the ball to establish a pattern for the group. (Each person must remember who they receive the ball from and who they have thrown it to.)
  4. Once everyone has received the ball and a pattern is established, introduce more balls, so there are always several balls being thrown at the same time – still following the set pattern.
  5. Continue this process until the throwing becomes impossible or someone stops the group to pause.


Often, in the work we do, we get into patterns of doing activities. In the whirlwind of everything that is going on, we often don’t have the opportunity to pause, reflect on what we are doing, and question if it could be done differently. Established patterns may not work when workload increases.

  • What did you notice?
  • How often do you stop to be curious about what you are doing?
  • How often do you take a “bird’s-eye” or “balcony” view of your work?
  • How could you apply the learning from this activity in your day-to-day work?

Adaptive systems are constantly changing, so this exercise serves to emphasize the importance of taking a “view from the balcony” – so we can take a high-level view of what is happening and identify opportunities for improvement.

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