Marlot Kuiper

273 Conclusion with the objective to gain a fine-grained understanding of how checklists work. An ethnographic study from a routine perspective allowed me to see individuals acting within teams, and to see their agency within organisational structures. Ethnography offered a rich, in-depth and holistic approach to studying the dynamics between (shared) assumptions, beliefs, values, objects, and everyday practices. In this sense, ethnography allowed me to see things other methods cannot reach (Walshe & Boaden, 2005). In comparison to other ways of working, such as doing surveys, structured interviews or even a combination of interviews and document gathering, the typical advantage of ‘being there’ is that as a researcher you are able to observe all different kinds of occasions and watch actors interact (Van Hulst, 2008). The ethnographic observations involved more than merely describing actions. A routine perspective allowed me to recognize patterns of action, and subsequently analyse why patterns occur as they do, and what the underlying meanings for professionals are. By looking at (inter)actions, I have been able to elucidate how professional routines work to enhance or weaken the checklist routine. For instance, the experienced authority of the surgeon can make it difficult for other teammembers to speak out when checks are being missed, or the collegial norms in specialized teams foster informal checks instead of systematic checks. As this thesis is about routines; the everyday inter(actions) that constitute surgical work, I decided that a narrative style was most suitable to represent these everyday experiences, and let the reader take a look in the surgery department for his/ herself. An ethnographic approach fits the research problem. Still, the approach taken and the choices made have some backdrops and require critical reflection. I will discuss four main points, and argue how some of the limitations create venues for future research. The professionals’ perspective First of all, this dissertation explicitly took the perspective of professionals (medical specialists) working in surgical care. By focusing on their perspective, it might come across as if other perspectives - patients, hospital boards, inspectorates – are less relevant. Although I do believe that other perspectives are relevant to consider, the choice to focus on (frontline) professionals, was purposefully and mindfully made. In taking the professional perspective, I answer to studies taking a managerial perspective asking question as how to make professionals comply with standards (e.g. Weske, 2019). Especially in 8