Patient Experience at Duke University Hospital

At Duke University Hospital, our mission is to put the person who needs our care at the center of everything we do.

That's why we're ranked among the nation's best hospitals and ranked #1 in the Raleigh- Durham region for the 19th consecutive year. It's also why we've received magnet designation, the nation's highest recognition for nursing excellence.

Operations Updates

Duke MyChart is an online resource for connection with your care team, keeping track of your health information, learning from the health library, and managing appointments. It's secure, free, and can be accessed anytime through a web browser or mobile app.

With a Duke MyChart account, you can:

  • View your medical recods, test results, visit notes, and more.
  • Schedule and manage appointments.
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  • Keep track of prescriptions and request renewals.
  • Review and pay bills.
  • Watch videos or read information about your health in the health library.

If you would like to sign up for Duke MyChart, please call 919-620-4555 or 800-782-6945 to receive an activation code. You may also ask to sign up at your Duke provider's office. To sign up online, visit DukeMyChart.org/Home and select "Sign Up Now."

Until further notice, all patients, visitors, and team members are required to wear a mask while in common areas of Duke hospitals and clinics.

Patients and visitors can wear their own mask, or one will be provided. All patients will wear masks in common spaces, such as waiting rooms, cafeterias, and hallways. Patients and visitors in our hospital should wear their mask when a Duke team member enters their room and when traveling to and from procedures

Duke Health is beginning to offer the newly reformatted COVID-19 booster shots. This formulation of the vaccine provides greater protection against the omicron variant of COVID, including the BA.4 and BA.5 subvariants currently in circulation in our community and across the country.

The bivalent booster shots were approved by the U.S. Food and Drug Administration and the Centers for Disease Control and Prevention for individuals who have had the initial series of the vaccine. The Pfizer booster is available to those ages 12 and older, and the Moderna booster is available to those 18 and older.

Those who recently received an initial vaccine shot or a booster should wait two months before getting the new booster, and anyone who recently tested positive for COVID may consider waiting 90 days after the onset of symptoms or a positive test. 

Eligible team members can schedule an appointment through the Duke Covid Vaccine website

DUHS VISITING OBSERVER POLICY (NON - PHYSICIAN)

Definitions:
Affiliate Student: An affiliate student is not a visiting observer. An affiliate student is an individual 18 years of age or older, enrolled in a DUHS or Duke University educational program,
or participating from another institution and participating in a clinical practicum through a formal affiliation contract with DUHS. Students who come to DUHS as a part of a formal
affiliation contract are under the auspices of the Clinical Education Department at each entity.

Contact information:

  • Duke University Hospital and Clinics – 919-684-4396
  • Durham Regional Hospital – 919-470-4293
  • Duke Raleigh Hospital – 919-954-3548

Students participating in a formal, contractual clinical experience at DUHS will comply with the terms of the Clinical Affiliation Agreement.

Non-Physician:  An individual who has not completed a medical residency program, and is not licensed to practice medicine as a physician.
Sponsor: The department/unit manager and/or division chief responsible for the actions of the visiting observer.
Tour Group: A group of observers requesting to tour an entity or department within DUHS. Tour groups will not be permitted an observation experience unless the group has an approved
affiliation with DUHS.
Visiting Observer: An individual 18 years of age or older, who attends a DUHS facility for a period of no more than 14 days in a 30 day period of time for the purpose of observing the
performance of clinical and non-clinical duties, systems or processes.

Level:
Personnel:
Competencies/Skills:
Required Resources:
Policy Statement:

DUHS will accommodate reasonable requests by Sponsors for visiting observers as long as the requirements set forth in this policy are met. Visiting observation experiences may be scheduled
Policy/Procedure: DUHS Visiting Observer Policy (Non-Physician) for up to a maximum of 14 days and must be scheduled within a 30 day period of time. Subsequent observations may not be scheduled. Reasonable precautions will be taken at the time of the observation to minimize the release of protected health information and comply with The Joint Commission, the Centers for Medicare and Medicaid, and DUHS policy.
This policy does not apply to prospective employees visiting as part of the employment interview process.
This policy does not apply to vendors as they are responsible for following the Status Blue process.

Groups not Governed by this Policy
1. Physicians

The Duke University Hospital (DUH) Credentialing Verification Office, the Duke Raleigh and Duke Regional Hospital Medical Staff Services offices maintain the records for visiting physician observers who:

  • are physicians who are fully trained and have completed a residency and/or fellowship program, and
  • are supervised by a credentialed member of the medical staff at the applicable entity, and
  • are observing clinical activities performed by the medical staff.

The observation policy and visiting observers form to be used by this group may be obtained by
contacting:

  • DUH Credentialing Services Office (919-684-4022). Includes Duke Primary Care, Private Diagnostic Clinic and Duke Home Care and Hospice.
  • Duke Raleigh Hospital (919-954-3106)
  • Duke Regional Hospital (919-470-6253)

2. Affiliate Students
Students who come to DUHS as part of an approved affiliation contract are under the auspices of the Clinical Education Department at each entity. Students participating in a formal, contractual
clinical experience at DUHS will follow the Clinical Affiliation Agreement. An Affiliate Student is not a visiting observer.

Special Circumstances
Sponsorship for the following lies with Duke Visa Services or the Nursing Office of Global and Community Health Initiatives (OGACHI). The documents attached to this policy are required of
all Foreign National or International Nursing observers.

Policy/Procedure: DUHS Visiting Observer Policy (Non-Physician)

1. Foreign National Visiting Observers
Foreign national visiting observers visiting a Duke entity for nine or more days are required to contact Duke Visa Services [919-681-VISA (8472)]. Duke Visa Services should be notified 60 days prior to the visit to approve such person’s participation as a visiting observer. International visiting observers must meet the same requirements as national visiting observers.
2. International Nursing Visitors
The International Visiting Nurses Programs are managed by the Duke University School of Nursing Office of Global and Community Health Initiatives (OGACHI) in conjunction with Duke University Hospital Clinical Education and Professional Development (CE/PD), in consultation with the relevant academic departments or specialty areas.
Web link to the program overview and application process:
https://nursing.duke.edu/centers-and-institutes/ogachi-office-global-and-community-healthinitiatives/program-options
Procedure
The visiting observer is required complete the attached forms, review the education modules, and submit the documentation to the Sponsor at least 7 days prior to the observation experience.
Failure to follow through on this requirement will result in the rescheduling or cancellation of the experience. The Sponsor is responsible for maintaining the documentation for a period of 6 years.

The Sponsor is Responsible for:
1) Ensuring the Visiting Observer Agreement (Attachment A) is complete. Prior approval of the department manager or director is required in writing before the observer may visit, observe, or tour any department.
2) Ensuring the Visiting Observer planning to be on the hospital/clinic campus for one to 14 days completes the:

  • Visiting Observer Agreement (Attachment A)
  • Duke Confidentiality Agreement (Attachment B)
  • Background Check (Attachment C)
  • DUHS Checklist and Immunization Attestation (Attachment D) (For Flu Vaccine written proof consist's of a form signed by the practitioner who administered the vaccine.)

In addition, visiting observers are required to review and attest to reviewing (in writing) the:

  • Duke Medicine Code of Conduct (Attachment E)
  • DUHS Patient Rights and Responsibilities (Attachment F)
  • HIPAA Privacy and Security Training (Attachment G)
  • Response in an Emergency

3) Ensuring the visiting observer is provided and wears a Duke University Health System issued identification badge at all times. The sponsor will obtain the unique identification number for the visiting observer. The fee for the badge is the responsibility of the sponsor.
4) Confirming the visiting observer appears to be in good health and free from obvious contagious conditions which may risk patient safety (such as common cold, upper respiratory illnesses, fever) on the day(s) of their visit.
5) Escorting/accompanying the visiting observer at all times during the designated time period of the visit to ensure patient and visiting observer safety, patient confidentiality, and the protection of DUHS proprietary information.
6) Obtaining patient authorization from the patient prior to observing or interacting with the patient or participating in patient rounds. The visiting observer may not participate in any hands on care of the patient.
7) Ensuring the visiting observer is in the presence of the Sponsor/Sponsor designee at all times.
8) Ensuring the visiting observer understands that s/he may not access patient information housed in the medical record.

Patient Authorization
Patient authorization must be obtained when the visiting observer is present during examination or treatment. Patient authorization may be provided orally, but must be witnessed by the Sponsor/ Sponsor designee. The patient has the right to refuse to be seen, have his or her protected health information revealed, or talk with or see individuals not officially connected with the hospital, e.g., visiting observers. This right must be honored.

Visiting observers who fail to maintain the confidentiality of information learned during the course of the observation will be denied future observation experiences at DUHS entities.

Citations:
Policies:
Authoritative Source:
Additional References:
45 CFR Part 160 and Part 164, Subparts A and E
Attachment Names:
Attachment A - Visiting Observer Agreement.pdf
Attachment C - Visiting Observer Background Check.pdf
Attachment D - Visiting Observer DUHS Checklist.pdf
Attachment H -Response in an Emergency.pdf
Attachment E - Duke Health Code of Conduct Integrity In Action.pdf
Policy/Procedure: DUHS Visiting Observer Policy (Non-Physician)
Attachment G - Visiting Observer Orientation.pdf
Attachment B - Confidentiality Agreement 2015.pdf
Attachment F - Patients Rights and Responsibilities.pdf
 

DUHS VISITING OBSERVER POLICY: PHYSICIANS

Purpose: The purpose of this policy is to provide a framework for sponsorship of visiting observers in the DUH Department of Pharmacy.

Policy Statement:
a. The DUH Department of Pharmacy (DOP) is committed to providing a high-quality job shadowing experience to visiting observers interested in pursuing admission to a school of pharmacy.
b. Those completing a shadow experience will observe and have no participation in clinical or non-clinical functions, products or technology, business processes or workflow within the DOP.
c. The DOP will accept visiting observers on a case-by-case basis, dependent on visiting observer interest, program availability, and other considerations as applicable as long as the requirements set forth in this policy are met. Visiting observation experiences may be scheduled for up to a maximum of 14 days (Monday through Friday). Reasonable precautions will be taken at the time of the observation to minimize the release of protected health information and comply with The Joint Commission, the Centers for Medicare and Medicaid, and Duke University Health System policy.
i. This policy does not apply to prospective employees visiting as part of the employment interview process.
ii. This policy does not apply to vendors as they are responsible for following the

Vendor Mate process.
Level:
☐ Interdependent - asterisked [*] items require an order from a health care
practitioner licensed to prescribe medical therapy.
☒ Independent – no provider order required.
Personnel: DUH Pharmacy employees
Competencies/Skills: None
Required Resources: None
Definitions:
 Sponsor: The department/unit manager and/or Associate Chief Pharmacy Officer
responsible for the actions of the visiting observer.
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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 Visiting Observer: An individual 18 years of age or older, who attends a DUHS facility
for a period of no more than 14 days for the purpose of observing only, and not
participating in clinical and non-clinical duties, systems, or processes.
Procedure:
Approval Process:
a. All requests for job shadowing experiences shall be forwarded to the Sponsor or
designated member of the DOP Senior Management Group (SMG). Prior approval by
the Chief Pharmacy Officer is required before the visiting observer may visit, observe,
or tour any division.
b. Upon receiving a request, the Sponsor or designated member of the DOP SMG will
contact the visiting observer and provide the visiting observer with the Non-Physician
Visiting Observer Forms (see attachments).
c. The visiting observer is required to complete the attached forms, review the education
modules, and submit the documentation to the Sponsor or designated member of the
DOP SMG at least 7 days prior to the observation experience. Failure to follow through
on this requirement will result in the cancellation or rescheduling of the experience. The
Sponsor or designated member of the DOP SMG is responsible for maintaining the
documentation for a period of 6 years.
i. Visiting Observer Agreement (Appendix A).
ii. Duke Confidentiality Agreement (Appendix B).
iii. Background Check (Appendix C).
iv. DUHS Checklist and Immunization Attestation (Appendix D).
v. Duke Medicine Code of Conduct (Appendix E).
vi. HIPAA Privacy and Security Training (Appendix F).
vii. Response in an Emergency (Appendix G).
d. The complete request will be presented to the Senior Management Group (SMG) for
review and approval.
i. If approved, the request will follow the ‘Post-Approval’ process outlined below.
ii. If denied, the Sponsor or designated member of DOP SMG will inform the
visiting observer candidate expeditiously.
Post-Approval:
e. A member of the SMG will accept responsibility for the visiting observer and will agree
to arrange the visiting observer experience, or delegate responsibility for the visiting
observer and responsibility of arranging the visiting observer experience to an
appropriate member of the DOP staff.
f. The responsible staff member will ensure ongoing communication between the visiting
observer and the designated member of the SMG or designated member of the DOP
staff.
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
Page 3 of 13
g. The designated member of the SMG or designated member of the DOP staff will work
to ensure all required forms and necessary documentation are completed prior to the
visiting observer’s start date.
i. The job shadow experience is subject to cancellation at any point before or
during the job shadow experience should any of the requirements outlined in this
policy and procedure fail to be met by either the Sponsor or designated DOP
SMG or visiting observer.
Exceptions:
a. The following exceptions to this policy exist:
i. Students attending schools of pharmacy located within the state of North Carolina.
ii. Students attending schools of pharmacy located outside the state of North Carolina.
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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REFERENCES
Citations: None
Authoritative Source: DUH Pharmacy Senior Management Group/Administration
Additional References: None
Associated Policies: None
Attachment Names:
a. Visiting Observer Agreement (Appendix A).
b. Duke Confidentiality Agreement (Appendix B).
c. Background Check (Appendix C).
d. DUHS Checklist and Immunization Attestation (Appendix D).
e. Duke Medicine Code of Conduct (Appendix E).
f. HIPAA Privacy and Security Training (Appendix F).
g. Response in an Emergency (Appendix G).
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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Appendix A
DUKE UNIVERSITY HEALTH SYSTEM
Visiting Observer Agreement
(Non-Physicians and Non-Physicians in Training)
I, , will be participating as a visiting
Name
Observer, under the direct supervision of __________________________(Sponsor) and sponsored
by the department of beginning
Department Name
, 20 and concluding , 20 .
Day/month Day/month
Purpose of the Activity:
Please provide 3 measurable goals and 3 objectives for meeting those goals.
As a visiting observer, I understand that I do not have any clinical privileges and will not
engage in any type of clinical activity while I am at (name of
hospital/clinic). I also understand that, in the event that I am requested to participate in any
clinical activity, I must decline. I understand that I must be escorted by my Sponsor/Sponsor
designee at all times.
I will be participating in certain learning activities at
(name of hospital/clinic). In conjunction with these activities, I may come in contact with patient
confidential information through my Sponsor. In consideration for my being allowed to
participate in this activity, I hereby acknowledge and agree that I will in no way copy or preserve
by paper writing, electronic, picture, or by any other means any patient specific information nor
any patient identifying information.
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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Further I acknowledge and agree that I have signed the Duke Confidentiality Agreement
and will not communicate nor discuss any patient specific information with anyone except those
involved with learning activities who are also workforce members of the Duke Health Enterprise.
I promise and agree to keep confidential all patient information and to respect the privacy of all
patients.
In the event of an emergency, I will follow my Sponsor’s instructions.
I make these promises and representations freely and voluntarily, and I understand that
others are acting in reliance on them.
Signature of Visiting Observer Date
Print Name
Permanent Address
Telephone Number (home) (mobile)
As the Sponsor of this Visiting Observer, I acknowledge that I am responsible to assure that the
activity remains in compliance with all established policies and procedures and that the privacy
and confidentiality of our patients is respected.
I also acknowledge that I am responsible for escorting the Visiting Observer continuously during
the observation experience.
As part of this Observation, I attest that the Visiting Observer may be in the following areas:
Name of Division Chief or Department Manager Telephone # eMail Address
Signature of Division Chief or Department Manager Date
******************************************************************************
*************
If Visiting Observer will be in multiple departments, more than one Administrator/Clinical
Director signature may be necessary.
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
Page 7 of 13
Name of DUHS/PDC Administrator or Clinical Director (Print)
Signature of DUHS/PDC Administrator or Clinical Director Date
To be kept on file in the Sponsor’s office.
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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Appendix B
Duke Confidentiality Agreement
See Attached
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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Appendix C
DUKE UNIVERSITY HEALTH SYSTEM
Visiting Observer Background Check
Have you ever been convicted of any offenses other than a moving traffic violation? (You must include any
and all felonies or misdemeanors.) An example of a common misdemeanor is a “worthless check”.
 No
 Yes. If yes, please explain nature of crime, date, and place. State whether the crime was a felony
or misdemeanor. State whether the crime was a federal or state offense.
List any pending court or trial dates. Please explain nature of charge, date, city, and state.
With respect to billing for, or delivery of health care services, have you ever been investigated by, charged
with, or listed by a Federal or state agency as excluded, debarred, suspended, or otherwise ineligible to
participate in Federal or state programs, including Medicare and Medicaid, or do you have any current
reason to believe that you may be so listed in the future on the Department of Health and Human Services
Office of the Inspector General Cumulative Sanction Report or the General Service Administration List of
Parties Excluded from the Federal Procurement and Non-Procurement Programs?
 No
 Yes. If yes, please describe the nature of the sanction. Include the name of investigating agency,
date, nature of changes, and disposition.
As the Visiting Observer, I, , certify that I accurately and truthfully answered
the above questions related to my background.
Name of Visiting Observer (Print)
Signature of Visiting Observer Date
To be kept on file in the Sponsor’s office.
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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Appendix D
Duke University Health System Checklist and Immunization Attestation for Non-Physician Visiting
Observers
Observer Name (Print) Observer Telephone Observer eMail
Observer Signature
Sponsor Division Chief / Department Manager Sponsor Telephone Sponsor eMail
Division Chief / Department Manager Signature
Dates of Experience Location of Experience
Item Initials (Sponsor) Date Complete
Visiting Observer Agreement signed
Confidentiality Agreement signed
HIPAA Privacy and Security Training reviewed
Integrity in Action – Code of Conduct reviewed
Patient Safety Training reviewed
Immunization Status
Sponsor
Initials
Date
TB status: Note date of last TB test. If positive due to BCG or past TB
exposure, note date of negative chest x-ray report. Observers currently being
treated for TB may not participate.
Rubella (“German” measles): lab evidence or rubella immunity or one dose of
live rubella vaccine on or after 1st birthday.
Varicella (chickenpox): lab evidence of varicella immunity or two doses of
varicella vaccine.
Measles (Rubeola): physician-diagnosed disease or lab evidence of immunity or
two doses of live measles containing vaccine. Note: documentation not required
for observers born before 1/1/1957.
Mumps: physician-diagnosed disease or lab evidence of immunity or one dose
of live mumps containing vaccine on or after first birthday. Note:
documentation not required of observers born before 1/1/1957.
MMR administered on _____________________________________________.
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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Appendix E
Duke Medicine Code of Conduct, Integrity in Action
See Attached
Appendix F
HIPAA Privacy and Security Training Module
See Attached
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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Appendix G
Response in an Emergency
Duke University Health System
Evacuations
1. Horizontal
Emergency Phone Numbers
2. Vertical
Duke Police - 919-684-2444
3. External
Emergency & Fire DRH - 222
Emergency DUH - 911
Emergency DRAH - 3111 (fire); 39111
(emergency)
Follow instructions of DUHS staff in all
emergencies relating to the facility
DRH Information - 919-470-4000
DUH Information - 919-684-8111
Infection Control
DRAH Information - 919-954-3000
Hand washing is your best protection
against
acquiring an infection. Wash your hands
Hospital Emergency Codes
before & after contact with patients, before
Security Alert - Code Gray
eating & drinking, & before putting or after
Infant/Child Abduction - Code Pink
removing protective gear.
Fire - Code Red
Cardiac Arrest - Code Blue
Personal protective equipment (PPE) is
Chemical Spill - Code Orange
available for your protection & use.
Choose
Utility Failure - Code Black
gowns, gloves, face protection, masks, etc.,
Emergency Plan Activation - Code Triage
as required by OSHA when handling
patients.
In Case of Fire
If you are ill with fever or diarrhea or have
a
Remove all persons from danger
rash or skin lesion, you are not permitted to
Alarm - pull manual alarm & dial 911
work in the hospital.
Contain - close doors & windows
Extinguish fire
Restraints
Fire Extinguisher Directions
Clinical - physical restrictions for
therapeutic
Pull pin
interventions or patient self-protection
Aim at base of fire
initiated by clinical staff. Clinical staff
must
Squeeze handle
do appropriate monitoring of clinical
restraints.
Sweep nozzle
Administrative - physical restrictions of
Policy/Procedure: DUH Pharmacy - Visiting Observer Policy and Procedures
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Smoking
patient in custody of a law enforcement
agency
Duke Medicine is smoke free. Smoking is
not
permitted on the Duke Medicine campus.
Patient Confidentiality
Chemical Hazards
Patient confidentiality must be protected at
You have a right to know about hazardous
all times. HIPAA requires that protected
health
chemicals used in this facility. Material
information must not be shared.
Safety Data Sheets (MSDS) are available
which explain chemical hazards &
appropriate personal protective equipment.


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Patient Experience Guiding Principle

To provide a safe, personalized care experience that ensures all feel respected and supported -- every person, every time.