Marlot Kuiper

214 Connective Routines the computer devices where the registration has to be done are positioned at the back of the theatre 24 , the digital checklist and the poster were mostly considered complementary. The intentional use of the later introduced whiteboards however, was less clear. A scrub nurse told me: “At first, there was this poster on the wall, representing the checklist. When we did the time-out, we looked at it. That was fine, then, wasn’t it?” [as a rhetorical question]. “Then at once, a month or so ago, there was this meeting organised for all OR personnel, and there they told us that these boards would be implemented. It was said: “From tomorrow onwards, there will be boards in the theatres, and you have to fill them out.” So a new physical representation of the rule entered the OR. A whiteboard that had to be filled in. But by who? And with what purpose? That remained fuzzy. In contradiction to the posters that are on the wall, the tabloid-sized whiteboards afford picking up and filling out checks (actual properties). Although the whiteboards indeed afford the possibility to fill out the checks, they herewith do not allow for registration. In the conversations, different respondents pointed out that they did not get what the purpose of filling out the checks on the whiteboards was, as registration had to be done in the software system anyways (perceived properties). The actions that artefacts afford thus matter in relation to others. The whiteboard affords to tick off boxes, but not for the purpose of making actions transparent by registration. Registration in Plainsboro has to be done through software system EZIS. St. Sebastian’s In St. Sebastian’s they work with “old fashioned paper”, according to their own sources. The three-page paper checklist functions as the only model for the routine. Many respondents from different disciplines apologetically stated that “luckily, things will soon be modernized.” Paper is not only seen as outdated, but even as ‘unprofessional’. Especially surgeons referred to paper’s vulnerability, and the lack of fit of this material with the body liquids that are all around in the operating theatre. Besides an unprofessional look of a paper checklist with blood drops on it, a couple of surgeons underlined lacking hygiene. At the same time however, paper does afford some flexibility a software system does not. Whereas the digital checklist in Plainsboro’s software system only 24 For more details, see paragraph 7.3.2 on spatial dimensions