Although scholars have begun theorising the social notion of collective reflection in organisations, empirical studies illustrating these often neat theoretical conceptualisations are still rare. Based on a longitudinal case study (the introduction of lean production at an emergency care unit), we address this need by applying a practice approach. Collective reflection in the present empirical case is manifold: it is characterised by several activities, each serving a specific purpose and enacted according to different temporal rhythms. Our inductive theorising broadens the theoretical conceptualisation of collective reflection in organizations: we propose value creation as a ‘point of reference’, in order to account for what exactly actors step back from when collectively reflecting in organising. We found that collectively reflecting in organising means actively creating multiple local co-presences. We suggest that the current conceptualisation of collective reflection as a discursive practice itself calls for empirical substantiation.