Marlot Kuiper

219 conversation. The same goes for the surgical drape, that is used for covering the patient. The surgical drape secures sterility, but also physically separates surgery from anaesthesia by putting up a ‘drape wall’. Herewith, the surgical drape puts up a physical barrier between two professional groups. In the previous chapter, I illustrated how routine interactions can reinforce notions of ‘us’ and ‘them’, rather than firm connections between professional groups. Also material objects, such as tables or the surgical drape mediate interactions and can hinder firm connections, by literally keeping professional groups separated. These artefacts thus mediate interactions in the theatre, and can limit affordances of artefacts that represent the checklist rule. At first sight, paper for example does seem to allow for incorporating the artefact in the actual performance of the routine as one can take it to the surgical table. Nonetheless, other objects in the room might hinder active engagement and ‘crossing borders’ (both literally and figuratively speaking) as physical barriers are put up. To summarize, the spatial affordances matter in two important ways. Firstly, the spatial affordances matter for ‘accessibility’; information input on a computer is limited to spots where a computer device is located, but at least actants know where to find it, and the checklist information can be accessed from different locations simultaneously. From the paper checklist on the other hand, there is just one copy available that can be accessed from one location at the time. Just because paper can be accessed from anywhere, actants have no clear reference points of where to find the checklist. Secondly, spatial affordances matter for ‘connectivity’; as the computer device where the checklist has to be registered in Plainsboro is located at the back of the operating theatre, checking and registration become de-coupled. The paper checklist in St. Sebastian’s can be brought to the centre of attention, but other artefacts in the room can hinder connections between routine participants. The final subparagraph takes into account the temporal dimensions. 7.3.3 Temporal dimensions Besides the material and spatial dimensions as identified in the theoretical chapter, I identified temporal dimensions during the ethnographic fieldwork. Because of the episodic character of the observations, there have been time intervals in-between the observations 25 . Therefore, I have been able to observe artefacts at different points in time. 25 See chapter 4 for methodological accounts 7