Patient safety is about more than just the absence of harm

For most of his 26-year nursing career, Dr. Glenn McRae PhD'18, BN'98, BSc'94 has worked in quality and patient safety roles. However, when he first graduated from UCalgary Nursing in the late '90s, he thought he’d have a long career in the military. 

McRae served in the Canadian Armed Forces, worked in the Middle East and in regional and provincial health authorities in two provinces. He has completed additional training in critical care nursing and in quality and patient safety and has taught and consulted on a variety of patient safety topics across North America and the Middle East.

He describes his time in Saudi Arabia as “undoubtedly one of the highlights in my life and work experience” when he was recruited as a nurse clinician [educator over there]. In three years, he worked through a variety of roles including as Head Nurse and Quality Improvement Nurse. 

“I introduced the CTAS [Canadian Triage and Acuity Scale] to the site, supported a successful Joint Commission Accreditation application, had a brief career as an 'edutainer' using a 'SNL-like fake news' approach to foster engagement in quality and learned how to be an expat," says McRae. 

“We moved to Jeddah in August 2001 and six weeks later, 9/11 happened. I will never forget that tragic day; a day we tell time from. I will also never forget the unique perspective I gained while living in the Middle East through the years that followed. Ultimately, it was my work in the Kingdom that put me on the career path that I still walk today.”

Currently, McRae is based in Kelowna, BC as the vice-president for Quality, Research and Academic Affairs with Interior Health. He was previously their Chief Nursing Officer and Professional Practice Lead and Executive Director for Quality and Patient Safety. In 2021, McRae received the annual Health Quality BC Quality Awards runner-up award as a Quality Culture Trailblazer. 

On Oct. 5, he’ll be giving his talk “My Accidental Career in Patient Safety: from gorillas to Swiss cheese and beyond” at the Faculty of Nursing’s 2024 Marguerite Schumacher Memorial Alumni Lecture. As this year’s keynote lecturer, McRae will share the key moments of tension and curiosity encountered in his practice in a story-based narrative that highlights how these pivotal times turned to informed choices.

Can you tell us a bit more about what you did in the Canadian Armed Forces and your work in the Middle East?
“I joined the military in 1989, initially serving as a Medical Assistant in the Reserves (Army). After my first year of nursing school, I was admitted to the Regular Officer Training Program (ROTP) assigned to the Air Force and supported to complete my BN. I was assigned to CFB Edmonton after I completed my BN program in December ’97 (fast-track CCNP program). I spent the next four years training and travelling within Canada, completed my Advanced Critical Care Training Program and led nursing services at CFB Meaford for Operation Parasol – which was one of the sites that housed and cared for the 5,500+ Kosovar refugees who came to Canada between May and August 1999.   

In 2001, I boarded a plane for Bosnia. I was headed to a village called Ćoralići to work in an Advanced Surgical Centre as a critical care RN, unfortunately when our team landed in Ontario, we learned that the mission was canceled. The in-theatre medical support had been downgraded and they no longer required a critical care team in the country.  Perhaps because of the disappointment of not getting to go on “tour” to Bosnia, my wife and I made the decision for me to leave the military and pursue some travel opportunities together. This took us to the port-city of Jeddah, in the Kingdom of Saudi Arabia.”

As an alum in both nursing and science, what are your fond memories of UCalgary?
“Of course there is the Den. But the things that flash to mind are so many of the social aspects of university from Bermuda Shorts Day to sitting on the hill by the Prairie Chicken having lunch on a sunny day to charging the photocopier card to get articles to take home for various papers.   

I remember classmates, professors (some as positive and others as negative role models), living in residence, and cheering on the Dinos. A pivotal moment for me was when I stepped in to a leadership role on the Undergraduate Conjoint Nursing Society. We organized “cabarets” but I also had the opportunity to sit on student council at MRU (MRC back then) and advocate for scholarship funds for nursing."

"I loved the administrative aspect of that work and I believe that the experience is part of the reason I ended up in nursing administration.”

How does quality and patient safety help us avoid unintended harm in our health-care system?
“It is more than avoiding unintended harm — it is about creating the conditions to support people in having the skill and discretion to make decisions every day that create quality and safety. One adage in the patient safety world, goes something like ‘just as health is more than the absence of disease, safety is more the absence of harm.’ 

A professor I studied under would often talk about the P-word: prevent. Everyone wants us to prevent everything; prevent medication errors, for example. We want that too, however, it falls into this idea of certainty. One thing that people who work in quality and safety learn about relates to the variety of human work and the messy reality of how care actually happens in a complex adaptive system.”