I usually start by gathering a group of fabrics and thinking about what sort of mood or aesthetic they convey. I then look through all of my saved patterns and on line until I find a suitable one (I'm not really interested in learning to draft patterns -- there are so many skilled designers out there). Sometimes a group of fabrics will sit for a long time before I find the perfect pattern. I do a ton of editing of my fabrics as I get familiar with the pattern. I take photos at every stage, which often result in more changes being made. The camera is essential because my design wall is in a small room and I can't get far enough away from it to get a long view, which I think is indispensable for making design decisions.