Marlot Kuiper

62 Connective Routines organised professional response to various pressures. Hence, checklists are ‘inescapable’ as professions need to take organising patient safety seriously. Safety is no longer about taking care of individual patients, but about responding to increasing complexity and information, risks, and demanding clients and society at large. As argued earlier, theorizations of ‘hybrid professionalism’ and ‘organised professionalism’ move beyond the idea that formal standards focusing on efficiency and accountability are unnatural for professionalism. From this perspective, safety checklists are inherent part of professional work. Classic professional values like personal case treatment and solidarity are maintained, while new demands like effectiveness and efficiency are simultaneously taken into consideration (Noordegraaf, 2015, 2016; Postma, Oldenhof & Putters, 2014). From this perspective, checklists can be considered the embodiment of mingled logics. The introductory quote of this paragraph on standards by Peter Pronovost, “Checklists are not Harry Potter’s wand”, illustrates frontrunning ‘hybridity’. Pronovost, trained as frontline intensive care specialist, delivers critical care to patients on a daily basis. Besides, he is Professor of Healthcare Management at the Carey Business School, Professor of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, and Medical Director for the Centre for Innovation in Quality Patient Care (University Hospitals, 2018). Pronovost moves beyond the assumption that checklists are technical instruments that once ‘out there’ will work out. On the contrary, he recognizes that implementing the checklist is not a simple matter of handing it out and asking medical staff to follow it: “It is not Harry Potter’s wand. Checklists might seem deceptively simple, but the effective use of them is a complex issue that encompasses different groups within the health care system and organisational change […]. My vision is that the science of how to do checklists is in its infancy.” (Pronovost, quoted by Laurance, 2009, p. 443). In the specific example of Pronovost, we see hybridization of roles , being both a frontline professional and a healthcare manager. From the perspective of organised professionalism flows the idea that professional and organisational values become naturally enacted within the same role. Hence, frontline professionalism becomes a matter of personal care treatment within organised professional processes in which checklists take part. Still, so called ‘checklist champions’ like Pronovost underline that the routine-uptake of a checklist is not self-evident and requires ‘organisational change.’