• Clinical Practice Guidelines
• Patient Safety
• Quality Improvement

Michel Foucault, in The birth of the clinic,1 introduced the concept of the clinical gaze in a wide ranging examination of the emergence of modern medicine. He proposed that the development of the clinical gaze, in which disease was viewed from a new perspective, changed the course of medicine and healthcare. “It is as if for the first time for thousands of years, doctors, free at last of theories and chimeras, agreed to approach the object of their experience with the purity of an unprejudiced gaze.”1 The new modern scientific medicine resulted in the perceptions of the doctor becoming more important than the views of the patient. The concept of the clinical gaze is a useful concept when one reviews the appearance of the patient safety movement over the past 20 years. The gaze of clinical medicine is transforming, as the safety of patients and person centred care are becoming essential requirements of care. The realisation that healthcare can be made safer is a recent phenomenon and achieving this goal remains a formidable challenge.2

In 2009, Leape et al assessed the state of the patient safety movement and the message was stark: “While efforts to improve patient safety have proliferated during the past decade, progress toward improvement has been frustratingly slow. Some of this lack of progress may be attributable to the persistence of a medical ethos, institutionalized in the hierarchical structure of academic medicine and healthcare organizations, that discourages teamwork and transparency and undermines the establishment of clear systems of accountability for safe care.”3 The development of the clinical gaze changed the relationship between clinicians and patients by emphasising the interpretation of the doctors over that of the patient. The resulting changes in the way health and disease were perceived benefited patients in many ways. …