This chapter begins with an overview of approaches that have targeted patient safety. It highlights their commonalities, especially the way they privilege formalized knowledge such as guidelines, evidence and idealized pathways. The chapter discusses three approaches that capture these aspects of front-line clinical work in some detail: experience-based enquiry, expansive learning and video-reflexive ethnography. The metaphor that best characterizes these approaches is that of 'roll-out of ready-made, best-practice solutions'. The chapter argues that they have produced important results, and they belong to a paradigm that regards the portability and transferability of formal knowledge as the principal function of patient safety intervention. It describes approaches that belong to a complementary paradigm, whose principal metaphor is not 'knowledge' but 'relating'. The chapter shows that the general parameters and practical achievements of approaches that fall under this second paradigm. It outlines the main differences between this complementary paradigm and the first paradigm.