Marlot Kuiper

66 Connective Routines 3.1 Introduction “The key is recognizing that changing practice is not a technical problem that can be solved by ticking off boxes on a checklist but a social problem of human behaviour and interaction” – Leape (2014) In the previous chapter, we have seen that present conceptualizations belonging to a popular ‘implementation discourse’ with a focus on how health care practices can be made to ‘adhere’ with the forefront of medical knowledge and how ‘simple checklists’ can be implemented (Wensing et al., 2006) seem to only reproduce the experienced problems of an ‘implementation gap’. Just like Peter Pronovost, Lucien Leape, professor at Harvard University and often cited scholar when it comes to patient safety and checklist implementation. Leape (2014), Leape and Berwick (2005), and Leape, Berwick, and Bates (2002) therefore underlined that ‘making a checklist work’ is not a technical matter, but a matter of human behaviour and interaction. In order to study checklist as a matter of behaviour and interaction, I need a ‘toolbox’ that fits such an approach. Routine Theory offers a useful lens with which to examine how teams work with checklists in daily practice. The question central to this chapter is: “ “What are organisational routines and how can they be used to study (professional) work and its standardization? ” 3.2 Foundations of Routine Theory Over several decades, a considerable body of research has been built up around the idea that routines are a crucial part of how organisations accomplish their tasks (March and Simon 1958; Cyert and March 1963; Nelson and Winter 1982; Cohen et al. 1996). Routines are a way to structure work in organisations, by enabling and constraining interactions among organisational members. Routines contribute to stability across time in organisational work, help to socialize new organisational members, and reduce conflict about how work gets done and who has responsibility for what (Cohen & Bacdayan, 1994; Feldman, 2000; Feldman & Pentland, 2003). Organisational routines are a key component of everyday life in organisations, though often taken-for-granted. Also in professional domains like healthcare, routines are at the core of daily activities and play a fundamental role in determining the organisation of professional service delivery (Goh et al., 2011; Greenhalgh, 2008). Examples