Availability for Work Policy (DUHS)

Policy Statement

All of Duke University Health System’s (DUHS) entities and departments are expected to maintain clear and consistent standards regarding attendance, tardiness, scheduled and unscheduled time off, and notification procedures for requesting or reporting absences. These standards support DUHS’s mission of delivering reliable, safe, and high-quality patient care while ensuring fairness and accountability for all team members. This policy applies to all regular, temporary, and part-time DUHS employees.

Supervisors are responsible for approving time off and managing attendance in alignment with this policy. Team members are responsible for notifying their supervisors in accordance with department procedures when they will be absent, late, or leaving early. Attendance expectations should be discussed regularly with all staff and reinforced through consistent performance management practices. Leaders are accountable for documenting attendance occurrences consistently using standardized DUHS corrective action forms.

For the Duke University policy, please see Availability for Work Policy (University).

Scope

This policy applies to all DUHS team members in regular full-time, part-time, and PRN positions.

Team members covered under a collective bargaining agreement are governed by the terms and procedures outlined in their contract.

Policy Details

Attendance Standards and Guidelines

DUHS expects consistent and reliable attendance from all staff. Attendance directly affects patient care, staffing ratios, and team member equity.

Key Standards

• One track applies to all attendance occurrences (no separate tracks for tardies or early departures).
• Missed swipes are not attendance infractions but are treated as behavioral performance issues.
• Occurrences are measured on a rolling twelve (12)-month period, meaning each occurrence rolls off twelve (12) months from the date of the original infraction.
• Leaders are responsible for monitoring attendance patterns within this period and consulting with their HR Business Partner (HRBP) for consistency and due diligence.
• Attendance will be managed in alignment with standardized DUHS corrective action forms and documentation.

Scheduled Time Off

Definition: Time away from work that has been pre-approved by a supervisor according to departmental procedures, or through an approved DUHS leave program. Examples include vacation, holidays, personal leave, medical or dental appointments, bereavement, and military leave.

Supervisors and staff should coordinate scheduled time off to minimize disruption to operations and ensure coverage. Scheduled time off must be pre-approved by the employee’s direct supervisor or designee in accordance with departmental scheduling protocols or a DUHS leave program. Approved leave should be recorded in the approved timekeeping system.

Unscheduled Time Off

Definition: Time away from work not approved in advance by a supervisor or covered under a DUHS leave program.

Consecutive Absences

When a team member is absent for up to three (3) consecutive scheduled shifts within a seven (7) calendar day period for the same personal or family* health reason, the time away is counted as one (1) occurrence.

*Family as defined by the definition in the bereavement policy.

Initial Period

• The first day of the consecutive absence is recorded as one (1) occurrence.
• The next two consecutive scheduled shifts (if out for the same personal health or family health reason) should be coded as PTOS.

Extended Period

• If the absence extends beyond three (3) consecutive shifts within the same seven-day calendar period, the fourth (4th) consecutive shift will trigger an additional occurrence and begin another round of consecutive absences.
• Team members out for an extended period are responsible for providing documentation (e.g., physician care note) upon return to work.
• The supervisor must coordinate with HR to ensure that leave eligibility (e.g., FMLA) is reviewed.

Holiday or Holiday-Adjacent

Because absences during designated holidays or adjacent workdays have a greater operational impact, they are treated with an enhanced accountability standard.

Definitions

• A Holiday is any day officially designated by Duke Health as a recognized holiday.
• A Holiday-Adjacent Day is any scheduled workday immediately before or after an official holiday.

Application

• If a team member is scheduled to work on a holiday or holiday-adjacent day and is absent, each day of absences of the holiday and/or holiday-adjacent day will count as two (2) occurrences.
• If the absence on a holiday or holiday-adjacent continues for multiple consecutive shifts for a reason that aligns with the consecutive absence standards, only the first day is counted, and it counts as two (2) occurrences due to an holiday or holiday-adjacent day absence.
• Subsequent days are treated under the consecutive absence guidelines in this policy.

Early Departure

Definition: A team member leaving work before completing at least 75% of a scheduled shift for a reason other than when the operational unit has requested or approved the departure.

• Leaders are responsible for clearly documenting whether a departure was operationally requested versus employee-initiated to ensure consistency and defensibility.
• Leaving work before completing at least 75% of a scheduled shift is an unscheduled absence and will be recorded as an early departure.
• Each instance of an early departure is one-half (1/2) of an occurrence.
• If a pattern of early departure is identified — defined as three or more instances within a 90-day period - the leader should meet with the team member to discuss the behavior. The conversation should focus on understanding the underlying cause, reinforce expectations, and determine whether other schedules, leave types, or supportive interventions are appropriate and feasible.
• Excessive early departures will result in corrective action, up to and including termination.

Tardy

Definition: A team member clocking in seven (7) or more minutes late from the scheduled start of shift or returning late from break or meal period without prior approval.

• Staff must notify their supervisor if they expect to be tardy.
• Each instance of tardiness is one-half (1/2) of an occurrence.
• Excessive tardiness will result in corrective action, up to and including termination.

Reporting Absences

• Team members must notify their supervisor as soon as possible prior to their scheduled shift according to departmental procedures.
• Departments must maintain written notification expectations and communicate them clearly to all staff.
• If a team member is absent for three consecutive days, the supervisor must assess potential Family and Medical Leave (FMLA) applicability.
• Staff may be required to call in daily during absences, unless otherwise approved.
• Failure to notify a supervisor according to procedure constitutes a No Call/No Show and will escalate per the corrective action path.
• If the duration of an absence is uncertain, team members must provide daily updates to their supervisor unless a specific return date has been confirmed.
• Supervisors should partner with HR and any other applicable areas, as guided, in requesting supporting documentation (e.g., medical certification) for repeated or patterned unscheduled absences.

Notification and Corrective Action Guidelines

DUHS will apply a progressive correction action model for all attendance issues. Before issuing any corrective action, leaders must consult with the assigned HR Business Partner (HRBP) or Staff and Labor representative to ensure consistent application and due diligence.

No Call/No Show

Continuity of patient care is a priority for DUHS. Understanding in advance the availability of team members for their shift is critical in fulfilling our mission. While we prefer team members to not have unscheduled absences, we want to reinforce a culture of accountability by asking that all team members at least call-in if not available to work. When a team member fails to notify their supervisor that they will not attend their shift, we consider that an escalated event.

As a result, No Call/No Show events will count as two (2) occurrences. Additionally, leaders can escalate corrective actions as follows:

No Call/No Show Escalation Path

• 1st Occurrence – Written Warning
• 2nd Occurrence – Final Written Warning
• 3rd Occurrence – Termination

Team members within their Duke Orientation and Evaluation Period are not eligible to appeal documented coaching or termination actions during this timeframe.

If a team member's record includes both No Call/No Show events and other attendance occurrences, corrective action will be determined by whichever path results in the higher level of corrective action.

Team Members in Corrective Action at Policy Implementation

• Retain the current corrective action step as of 1/1/2026.
• Two additional occurrences advance to the next steps (not to exceed Final Written Warning).
• Termination only if the occurrence threshold is met or exceeded and steps followed in issuing corrective action.
• HRBP consultation required for all disciplinary action and termination considerations.

Return to Duty

Staff returning after an illness-related absence may be required to provide documentation to EOHW from a licensed healthcare provider clearing them to return to work. Please refer to the Communicable Disease Policy for more details.

For non-health-related absences, leaders may require documentation supporting readiness to return, based on the nature of the absence.

Job Abandonment

Failure to report to work or contact a supervisor for three consecutive scheduled workdays constitutes job abandonment and will result in voluntary termination.

Prior to processing a job abandonment, the supervisor must confirm all due-diligence outreach (call, emails, certified letter if applicable) and review the case with the HRBP.

Effective Date

This policy becomes effective January 1, 2026, for all DUHS entities.