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This study examines how organizational and professional practices and beliefs related to patient safety influence (1) how health care providers and managers make sense of patient safety risks and adverse events, and (2) the flow and use of information for making improvements. The research is based on an ethnographic case study of a medical unit in a large tertiary care hospital in Canada. The study found that front\u2010line staff are task driven, coping with heavy workloads that limit their attention to and recognition of potential information needs and knowledge gaps. However, a surrogate in an information\u2010related role\u2014an \u201cinformation\/change agent\u201d\u2014may intervene successfully with staff and engage in preventive maintenance and repair of routines. The article discusses four key functions of the information\/change agent (i.e., boundary spanner, information seeker, knowledge translator, and change champion) in the context of situated practice and learning. 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