Marlot Kuiper

28 Connective Routines Next, routines never stand on their own. When you study a certain routine in isolation, you never truly get to see and understand why certain patterns (do not) emerge or change. Routines are inherently connected to each other, and to create a new routine, it has to ‘fit’ with existing patterns of action. Third, I search for explanations why discrepancies between artefacts and actual patterns of action emerge, to subsequently look for ways to better connect the envisioned routine, the artefact, with the actual behaviour. Paragraph 3.3 provides more detailed information about connections in the research perspective I developed. The purpose of this dissertation is threefold. First of all, I aim to provide rich and detailed descriptions of how professionals work with formal standards. Next, from a routine perspective, I aim to unravel patterns of action, ostensive dimensions and artefacts, and link them to each other, in order to explain why actants do what they do. Thirdly, the purpose is to identify implications for both theory and practice – with the ultimate goal to formulate lessons on how to develop routines that connect professionals, practices and artefacts. The research question central to this dissertation is: “How and why do professional standards work in performance-oriented medical practices?” The overarching question is split up into several sub questions. First, in the theoretical chapter (chapter 2) the core concepts of this study (professionals and standards) and their relation will be discussed. Thereafter, Routine Theory is used to develop a research perspective (chapter 3). After a discussion of the methods of this study (chapter 4), the empirical chapters (5, 6 and 7) each ‘zoom in’ at a specific part of the analytical framework (internal routine dynamics, routine interactions, and artefacts), as is visualized in figure 1. The sub questions are: