You Burn First
It may not be beautiful, but the process has to start somewhere. Whether it is a napkin, an empty matchbook or the back of a rejected layout. The idea needs to be sketched out, refined and refined again. Even once the initial sketch is then redrawn and then photographed and then brought into Illustrator revisions and improvements must take place if you hope to even get to some place close to satisfactory.
This is my process. The initial sketch which may look a little shabby. The sketch is then redrawn and positioned, searching for interaction and possibility. Refined and digitized and then fine tuned. Lastly, small embellishments are added. It may not be the best process, but everyone has to start somewhere.