Marlot Kuiper

76 Connective Routines (1) social connections, in terms of connections between people (2) connections between routines, and (3) connections between routines and artefacts. A first important type of connection are those between people. Various scholars have underscored that relational connections between people can have a powerful impact on their engagement and behaviour in organisational processes (Carmeli et al., 2013; Kahn, 2001, 2007). Furthermore, connections are associated with effective teamwork (e.g. Gittell et al., 2000). In describing new forms of professionalism, Noordegraaf and Steijn (2014, p.34) point towards ‘connective professionalism’ as a possible productive way to overcome boundaries: “Dealing with variety inside work and professional fields, as well as dependencies between professional and organisational fields, might become a crucial aspect of professional work instead of an obstacle for further professionalisation.” Hence, ‘connective professionalism’ emphasizes the relational side of professional behaviour, and focuses on mechanisms influencing relational dynamics. Literature on organisational routines pays explicit attention to connections. Feldman and Rafaeli (2002) state that routines inherently are about connections, because the connections between people that are formed as they jointly participate in organisational routines allow them to create shared understandings. In the first place, such connections will allow participants to create shared understandings about the specific task to be performed (that is, a shared ostensive pattern). In the second place, connections through routine performances will allow participants to develop shared understandings about the wider goals of the organisation. Specified to the case of this thesis, the presumption becomes that through the joined performance of the Surgical Safety Checklist, routine participants can generate firm shared understandings about what the checklist is and how it should be performed, as well as understandings about patient safety in general. In this study, I thus approach standards (as routines) as an inherently relational matter. The performance of a checklist routine is a collective effort and is about how people connect in the performance of a checklist routine. It is the interaction between people that matters, rather than what people think or do on their own. The frequency of interactions for instance, might enhance the strength of connections; when people frequently interact in the performance of a checklist routine, they will most likely share information and develop shared understandings (connectivity).