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.
The course is 2.5 hours long and can be offered at a variety of Duke locations to Duke Health employees and students.
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
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 be in contact shortly.
Frequently Ask Questions
Q: What is the Professional Accountability Program?
A: 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 .
Q: How do you define unprofessional behavior?
A: 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.
Q: How are incidents reported and tracked?
A: 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.
Q: For what kinds of incidents will a Peer Messenger be brought in?
A: 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.
Q: Are the incidents vetted for accuracy before a faculty or staff member is referred for a meeting with a Peer Messenger?
A: 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.
Q: If I am referred to meet with a Peer Messenger, will that information be recorded in my personnel file?
A: No, Peer Messenger conversations are confidential and designed to foster improved professionalism through awareness, understanding and support.
Q: If I am referred to meet with a Peer Messenger, will my department chair be notified?
A: No, Peer Messenger conversations are confidential. Only the faculty/staff member, Peer Messenger and oversight committee will have access to that information.
Q: Who are the Peer Messengers?
A: 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.
Q: Is this program just for physicians? Are nurses and other care team members also participating?
A: 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.
Q: What happens if a person has repeated incidents of unprofessional behavior?
A: 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.