Marlot Kuiper

231 7.5 Artefacts in performance-oriented contexts This chapter has predominantly focused on the artefactual arrangements of the checklist rule. I analysed how different representations of the Surgical Safety Checklist affect routine dynamics. In doing so, I also came across other artefacts that can act as intermediaries in routine performances, such as the surgical table the surgical drape, and the door of the theatre. In studying artefacts in performance-oriented contexts, one specific artefact that was not the initial focus on this study (representations of the checklist) drew particular attention while I was observing in Plainsboro Teaching Hospital. Screens that visualize progress in the various operating theatres were put up in different places in the surgery department. As these artefacts that ‘track performance’ influenced the performance of the checklist in specific ways, and they ‘physicalize’ a prominent theme that appears throughout this dissertation, I included these in the analysis. With the new, high-tech surgery department where digitalization was at the core, also came screens that visualize the progress of the interventions in the various theatres. The bars on the screen represent the progress in the theatres, also by indicating percentages, so everyone in the surgery department can track the process and see whether interventions are on schedule. For anaesthesiologists for example, the screen makes it more easy to monitor the process and therefore also more easy to decide when to enter the theatre. They can even monitor the process through a screen that is put up in the staff room. The screen therefore functions as tool that helps limit the amount of door openings – which benefits the air conditions in the theatre, and thus safety. At the same time, the screen incorporates a competitive element. As this artefact displays the progress in the theatres in one screenshot, it allows for a quick- view comparison. Professionals cannot only trace their own progress, but also progress of others. While I was in the anaesthesiology staff room, I picked up a conversation between two anaesthesiologist who were holding track of their theatres while drinking a cup of coffee. “Well, well, dr. de Vecht is on a roll!” [original: “…is lekker bezig!”] One anaesthesiologist said to the other. The bar on the screen representing the progress in the theatre where dr. de Vecht was operating, was clearly beyond the others. This statement of ‘being on a roll’ implicitly reflects the idea of ‘faster is better’. 7