I see a pattern I like in a magazine or online, then figure out who I’d like to make it for. About 90% of mine are for donation. So I find fabric suitable for recipient in my mind. I have almost never followed a pattern, but draw up my own sketch based on The inspiration quilt.
I spend a lot of time at the design board, tweaking and fussing, taking pictures, standing back to study it, walk away, revisit my choices. And finally start piecing. After the top is done, I wish the whole thing was done, and a debate ensues internally about whether I like this quilt or was it a big mistake, but alas, I persevere. Of course more motivation is needed for sandwiching, more inspiration for quilting, and then a jolt of discipline to make binding. Then I hand bind it over a few TV shows or a couple movies.