Marlot Kuiper

198 Connective Routines Furthermore, different groups (anaesthesiologists, surgeons) might have different understandings of a routine’s ostensive aspect (see the previous chapter). This chapter extends this view by showing that different groups may hold different understandings of what is important, and what is what is priority. When the checklist does generate a clash in terms of what should be done (first), it leads to the opposite effect of the envisioned ‘connections’, namely conflict (e.g. “You kept me waiting’ and “Look what you’ve done!”) In such situations, professionals illustratively refer to ‘us’ and ‘them’ rather ‘we’. To conclude, medical professionals pragmatically cope with checklists amidst high-paced circumstances. Real-life circumstances count and affect the extent to which the checklist is, and can be performed as a ‘hub’. This is partly a matter of ideas (chapter 5), but largely a matter of performances, strongly affected by real- life circumstances. The abstract patterns are affected by interacting routines, and often, conflicting routines. Hence, I argue that in such professional contexts, it might be more valuable to adapt practices to situational demands, rather than focusing on strict ‘compliance’ with artefacts. I have shown that professionals not so much actively try to preserve old values, but pragmatically cope with artefacts in other to find the most convenient way to incorporate a checklist in existing workflows.