Years ago I used to tie my quilts. It took too long to get it really tacked down well enough and I moved on to macine quilting.
Also the use of machine tacking ever so often was used at one time. But, the cutest one I saw was tacking down a length of satin ribbon by machine and tying it into bows for a little girl's quilt. Done like the tying or tacking, but adding the ribbons.
I have wondered how it would work to make tons of simple sewn finished flowers and just tacking them down in the center like the ribbons, but sewing a circle in the center. I think it would be cute and functional.
Another way to add interest would be to use couching yarn while using a tiny zic zag stitch. You could make designs or make it random like stippling.

As my late friend pat used to say, "There is more than one way to skin a cat". I know horrible saying, but, you get the idea.

One or two baby quilts with small bows (1/4" ribbon) zigzagged in place of ties; a wall hanging with buttons and yo-yos sewn through, metallic hand quilting accents, and outline hand quilting of the panel figures; combination of counted cross-stitch saying and pieced heart blocks in a heart-shaped wall hanging with boning along top curves to keep them upright; heirloom doilies and pieces of vintage linens included in otherwise pieced quilts...

Haven't tried it yet, but it's on my to-do list. Jean Kingwell quilts little X'es by hand instead of a regular running stitch. So cute! https://www.youtube.com/watch?v=Fp2pfQhjYNg

I used blue soutache which I stitched down along all the ditches of a tumbler quilt. Then I echo quilted the tumblers by couching down a thin piece of orangish rattail. It came out very nice, don't know that I'd do that for a quilt to be used since I'm not sure of the colorfastness of the soutache or rattail--they might bleed in the wash. There should be a picture in my profile.

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Oops, no there's not a pic in my profile. There is a pic in the 2016 UFO thread I think it's post number 945.

Rob

I hand quilt and machine quilt and tie, usually with crochet cotton or embroidery floss. I have used my emb. machine to quilt small blocks too.

The first quilts I made I tied because I was terrified to machine quilt. When I tried it for the first time, I had used polyfill batt and my regular sewing foot and it was a disaster, but my young daughter loved it horse panel quilt anyway.

I have since machine quilted, usually straight lines, and they come out to my satisfaction, but it takes a lot of thread and sometimes hides the prettiness of the fabrics I have spent a lot of time choosing. Since you don't really need miles of thread to anchor the three layers, I thought I might applique or outline stitch on the plain parts, or even try some fabric manipulation before hand.

It's interesting to hear what you've all done - any pictures to go along?

I helped a friend and her mother tie a quilt when I was a pre-teen, and I helped guild members tie quilts a few years ago. What a difference the years made! I still remember that first experience, crawling all over the quilt on the floor and having a great time. And I remember the second time, 50+ years later, how much my back hurt from bending over the table that was supporting the quilt. Now it's quilting (longarming) by machine for me!

I just watched the video of Jean's little x's. I want to try that. But I'm wondering why one doesnt take the thread and needle through all 3 layers to have a cross on front and back off quilt. I think i'd like to have crosses front and back. It's there a reason I'm not understanding for only going through the top and batting on the second part of the x?

Fabric manipulation?