Professional Accountability Program (PACT)

The DUHS Professional Accountability Program (PACT) aims to improve healthcare safety and quality by promoting a positive and safe work culture among faculty and staff. Specifically, PACT trains Duke faculty and staff to become Peer Messengers to help their colleagues uphold Duke’s core values (Excellence, Safety, Integrity, Diversity and Teamwork) in their day-to-day behaviors. When unprofessional behavior is reported, instead of seeking immediate punitive actions, Peer Messengers foster improved professionalism through awareness, understanding and support.

How do you define unprofessional behavior?
Unprofessional behavior is any behavior counter to DUHS and SOM policies, standards of conduct, or values, including behavior that is disruptive, intimidating, threatening, violent, inappropriate, or illegal.

How are incidents reported and tracked?
Incidents of unprofessional behavior can be reported: (1) in the (SRS), a centralized, confidential on-line reporting tool; (2) by phone, (919) 681-3906; or (3) to your direct supervisor.

For what kinds of incidents will a peer messenger be utilized?
Peer Messengers provide support and guidance around behavior that is reported to be disruptive to colleagues, learners, patients, or visitors. More serious behaviors are referred to DUHS and SOM leadership.

 Are reports vetted for accuracy?
Peer Messengers do not debate the merits of reports and instead review them to understand the causes, reduce/prevent their occurrence, and improve the patient experience. In peer organizations with similar programs, better awareness of reported issues and interaction with Peer Messengers reduced or eliminated future incidents.

What happens if a person has repeated reported incidents?
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, if repeated reports are submitted, the faculty or staff is referred to DUHS and SOM leadership.

 Are meetings with Peer Messengers recorded or reported?
Peer Messenger conversations are confidential and are not recorded in someone’s personnel file. Only the faculty/staff member, Peer Messenger, and oversight committee have access to specific information.

Who serves as Peer Messengers?
Peer Messengers are selected to participate in the PACT training program, which is currently geared towards physicians and nurses.

What does the training entail?
The training includes two courses:

  • Promoting Professionalism and Peer Communication in the Workplace. This course focuses on how communication and professional behaviors impact work culture and team building. Participants explore communication as a leadership skill, how effective communication enhances both team building and professional satisfaction, and specific wellness strategies and Duke resources.

Next Session: Thursday, September 8th, 5 p.m.- 6:30 p.m.
Register here for upcoming sessions.

  • Peer Messenger Training*. In July 2008, the Joint Commission released a national alert: “Behaviors that undermine a culture of safety,” which outlines the scope and negative impact of these behaviors. This training helps participants understand the relationships between behaviors that undermine a culture of safety and suboptimal outcomes, identify those behaviors within a “professional accountability pyramid,” and learn how to address those behaviors at three successive intervention levels.

Next Session: Thursday, September 22nd, 5 p.m.-6:30 p.m.
Register here for upcoming sessions.
*The above course is a pre-requisite.

PACT is led by a joint DUHS/SOM oversight committee.
Co-Directors: William J Richardson, MD and Diana McNeill, MD.
Administrative Director: Cynthia Gordon, RN

Additional Resources
Does your unit or department have a need around professionalism or professionalism training? If so, please email:
SharePoint Page
School of Medicine’s Statement on Faculty Professionalism