We aim to understand how public sector organizations practise ‘design thinking’ to respond to changing demands and develop alternative courses of action. The literature on design thinking is largely prescriptive; few studies analyse how change is actually brought about through situated design practices. Design scholars have therefore argued that such practices themselves should take centre stage as objects of analysis. We take an ethnographic approach to studying the design thinking journey of the Dutch Health Inspectorate, using participatory observations and interviews to collect our data. Drawing on the anthropological concept of ritualization, we identify two important mechanisms through which design thinking helped the Inspectorate disrupt existing organizational strategies and engage with stakeholders in a fundamentally new way.