Yesterday’s time-limited health improvement projects are becoming enduring communities, and we are all finding our new places in them. Russell’s reflections on active citizenship and democracy resonate as we navigate co-production and shared leadership.

Russell asks how to “listen better to what people in citizen and community space think they can do.” In our improvement community, we ask and see floodgates open. Patients whom clinicians previously assumed did not understand complex data are crafting novel approaches to displaying it. Communication challenges associated with a geographical distance between community members are being solved with the help of parent partners bringing expertise from lives as teachers, writers, and business owners.

Russell reminds us there is no rulebook for a community’s civic functions. So it’s all the more stirring to see clinicians, patients, and others figure out how to apply their assets—individually and collectively—to improving outcomes and shaping a community’s future together.