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Neither magic bullet nor a mere tool: negotiating multiple logics of the checklist in healthcare quality improvement

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journal contribution
posted on 12.04.2019, 10:44 by D Kocman, T Stöckelová, R Pearse, G Martin
Over two decades, the checklist has risen to prominence in healthcare improvement. This paper contributes to the debate between its proponents and critics, making the case for an Science and Technology Studies-informed understanding of the checklist that demonstrates the limitations of both the "checklist-as-panacea" and "checklist-as-socially-determined" positions. Attending to the checklist as a socio-material object endowed with affordances that call upon clinicians to act (Allen 2012, Hutchby 2001), the study revisits the efforts of a recent improvement initiative, the Enhanced Peri-Operative Care for High-risk patients trial. Rather than a singularised simple tool, this study discusses four different and relationally enacted logics of the checklist as a stop and check tool, a clinical prompt, an audit tool and a clinical record. Each logic is associated with specific temporality, beneficiaries, relationship with material forms, and interpellates (Law 2002) clinicians to initiate specific actions which can conflict. The paper seeks to make the case for intervention to improve such tools and consciously account for the consequences of their design and materiality and calls for supporting such settings and arrangements in which incoherences collected in tools can be locally negotiated.


National Institute for Health Research (NIHR) Health Services and Delivery Research (HS&DR) programme. Grant Number: 12/5005/10 Czech Science Foundation. Grant Number: 15‐16452S NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM)



Sociol Health Illn, 2019,

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/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Health Sciences


AM (Accepted Manuscript)

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Sociol Health Illn


Wiley for Foundation for the Sociology of Health and Illness



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