Marlot Kuiper

281 Conclusion Thirdly and finally, this thesis has shown how artefacts are employed to create a new routine, without awareness of how these artefact can work out in practice. Artefacts like software systems or paper checklists are not ‘technical instruments’, but they are political and can be used strategically. Professionals should therefore engage in conversations (with IT-developers and managers) about workable artefacts. Obviously, there is no blueprint for ‘what works’, but what works for now should be a matter of ‘trial and error’, in which this thesis emphasizes that ‘more artefacts’ to model a routine is not necessarily better. 8.7 Connective Routines In this dissertation I examined the standardization of surgical safety processes as the embodiment of an organisational logic in professional care. The central question focused on how standards work , thereto tracing on a micro-level how a professional standard embodying organisational values like rationality, objectivity and comparability finds its way in a professional working domain characterised by values like autonomy, collegiality and informality. Hence, this study shows what hybridity actually looks like . Creating connective routines proved a mindful, complex task. Surgery is, like other complex work activities, characterised by the constant emergence of contingencies that require ad hoc and pragmatic responses. It is difficult therefore, to strictly comply to ‘the rules of checklists’. Unpredictable flows of events make the connections between individuals, intersecting routines, and artefacts a continuous balancing act, that requires adaptability and decisions on the spot. Creating connective routines is thus not about ‘compliance’ but about responsiveness. Creating connective routines is hard work. 8