Duke Professional Accountability Program

The Duke University Health System adheres to the core values of Excellence, Safety, Integrity, Diversity and Teamwork. Each and every day, the people who make up this health system strive with admirable success to uphold these values in their interactions with patients, their loved ones, and each other. However, we are not perfect. Sometimes, our professional behavior slips below our high standards.

Led by an oversight committee comprised of Duke University Health System and Duke School of Medicine administrators and healthcare workers, the Professional Accountability Program (PACT) is an opportunity to teach Duke faculty and staff how they can support and guide their colleagues who might need help consistently upholding our core values in their day-to-day behaviors. Instead of immediately resorting to punitive action, we believe in confidentially supporting and guiding those who are struggling through the use of Peer Messengers.

Those who attend the PACT Program will be trained as Peer Messengers. Peer Messengers are expected to not only live by our core values, but also to be an active participant in helping ensure their colleagues at Duke are held to the same professional standard.

See a recorded overview of PACT by Co-Director Dr. Diana McNeill

There are two sequential courses in the PACT program:

Course 1: Promoting Professionalism and Peer Communication in the Workplace

Professionalism and peer communication are essential for a positive workplace culture, strong teamwork and overall healthcare safety and quality. Methods and strategies presented in this multidisciplinary training session are designed to improve communication, teamwork and conflict management skills. Participants will also receive an overview of the wellness resources available across Duke Health.

Learning objectives
After participating in this activity, attendees will be able to:

  • Discuss role of communication as a leadership skill
  • Review impact of professional behaviors on team building
  • Consider how effective communication enhances both team building and professional satisfaction
  • Describe the wellness strategies and resources available at Duke

Upcoming Virtual Sessions (register here)

Sept 17   5:00PM-6:30PM

Oct 15     5PM-6:30PM

Course 2: Peer Messenger Training

**Attendees are strongly encouraged to attend the “Promoting Professionalism and Peer Communication in the Workplace” course before receiving peer messenger training.

Behavior/performance that undermines a culture of safety by healthcare professionals is a threat to quality of care and patient safety, while also affecting staff morale and increasing cost burdens to a healthcare organization. In July 2008, the Joint Commission released a national alert titled “Behaviors that undermine a culture of safety” which outlines the scope and negative impact of these behaviors. Methods presented in this training are essential components of a plan to address these unprofessional behaviors.

Learning objectives

After participating in this activity, attendees will be able to:

  • Describe and discuss the relationships between behaviors that undermine a culture of safety and suboptimal outcomes
  • Identify a range or behaviors that undermine a culture of safety and describe a “professional accountability pyramid”
  • Articulate essential elements of an organizational infrastructure for addressing behaviors that undermine a culture of safety
  • Describe and discuss the essential elements of three graduate levels of interventions for addressing behaviors that undermine a culture of safety

Upcoming Virtual Sessions (register here)

Sept 9      5PM-6:30PM

Sept 23   5PM-6:30PM

Dec 2        5PM-6:30PM

Not seeing a course date that fits your needs? If you are interested in hosting a Professionalism course with your team or are interested in becoming a Peer Messenger for your department, please fill out the application below and we will contact you about other upcoming opportunities.

Submit a general interest application (individual/team) here

Looking for more resources? Visit the PACT SharePoint page (Duke netID needed)

Professionalism FAQs

As part of Duke’s ongoing commitment to professionalism, the health system’s Professional Accountability Program (PACT) was developed to improve quality, safety and the patient experience. It is designed to promote the highest standards of professional conduct and ethical behavior and support the delivery of high quality patient-centered care through improved communication and teamwork. The PACT is one of many institutional resources available to faculty, staff, students and patients and is aligned with the School of Medicine’s Statement on Faculty Professionalism. http://medschool.duke.edu/faculty/office-faculty-development/resources-facultyprofessionalism .
Unprofessional behavior includes anything that is counter to Duke University Health System and School of Medicine policies, standards for conduct and value-based based behaviors. Those behaviors can include anything that is disruptive, intimidating, threatening, violent, inappropriate, illegal or in violation of Duke University or Duke University Health System policies.
Incidents of unprofessional behavior can be submitted in the Safety Reporting System (SRS). The SRS is a centralized location for reporting concerns 24 hours a day, 7 days a week. The system allows confidential reporting that is protected by peer review privileges. Confidential reports can also be submitted by phone at 919-681-3906 or reported to your direct supervisor.
Peer Messengers will be brought in to discuss and provide support to faculty around behavior that is determined to be disruptive to colleagues, learners, patients or visitors. More serious or egregious action or behaviors will be referred to DUHS and SOM leadership to address and follow existing protocols.
The meeting with the Peer Messenger is not intended to debate the merits of the incidents or complaints. Rather the goal is to review them to better understand why they occur, reduce or prevent their occurrence, and improve patients’ experiences. In some cases, complaints may be based in part on problems involving policies, services or operations so these conversations will help Peer Messengers better understand and support the physician. In peer organizations with similar programs, better awareness of the issues and interaction with a Peer Messenger reduced or eliminated future incidents.
No, Peer Messenger conversations are confidential and designed to foster improved professionalism through awareness, understanding and support.
No, Peer Messenger conversations are confidential. Only the faculty/staff member, Peer Messenger and oversight committee will have access to that information.
Peer Messengers were selected from each department and, while they are not trained counselors, they have participated in a training program led by an oversight committee consisting of Duke University Health System and Duke University School of Medicine healthcare workers and administrators.
At this time, the PACT program is an effort specifically for physicians and nurses at some entities. However, the PACT program is expanding into other disciplines.
The experience of peer organizations is that faculty and staff who receive an intervention through the PACT program are significantly less likely to repeat the behavior. However, should repeated events occur, they will be referred to DUHS and SOM leadership to address the use of existing protocols and procedures.