Marlot Kuiper

196 Connective Routines Prioritization, emergency construction and negotiating responsibilities unfold into three overarching coping strategies: professionals work on it, around it, or without it. Working on it refers to trying to unite incompatible demands anyway, for instance by not explicitly prioritizing one routine over the other. Work around it refers to bending the rules to generate the most favourable outcome, for instance by outsourcing tasks to those without formal responsibility. Work without it refers to either working without the checklist, or without another routine, by explicitly prioritizing one task over the other. 6.7 A model for routine interactions in profession- al contexts The figure below translates the key findings of this chapter into an expanded routine model. The findings of this chapter give urge to expand the initial routine model (Feldman & Pentland, 2005) to explicitly take into account interacting routines. I have shown how demands emerge at the intersection of routines. These can either be backed in the organisation of the care process, or emerge unexpectedly. Professionals have to prioritize and (re)negotiate responsibilities. Tensions at the intersection of routines result in three different coping strategies, that range from working on it to working without it. The findings also point out how difficulties at the intersection of routines might reinforce internal routine dynamics. For instance, registration of the checklist procedure was already seen as a matter of ‘control’ detached from the intervention itself (Chapter 5). Because of the multiplicity of demanding routines, the idea of registration as a burden got strengthened. Hence, routine dynamics and interactions are inseparable, which implies that none can be fully understood in isolation. This underlines the contextual nature of professional work which is decisive for the creation of routines, and hence for understanding complex professional work processes.