Keeping Our Focus: Guidelines for Outside Employment

At the heart of our organization is a commitment to excellence and the well-being of our patient families. To ensure we continue to provide the highest level of care and service, we are introducing updated guidelines for employees regarding Outside (Dual) Employment.

Whether you’re a physician, an Advanced Practice Provider, or any member of our clinical or non-clinical staff, these guidelines are designed to help you balance external opportunities with your vital role here at Cook Children’s.

Under the guidelines, before employees start any new outside work—or if your current outside work situation changes—you must disclose these details to your department leader.

“The goal of these guidelines isn't to discourage your professional growth or opportunities, but to ensure that your external commitments don't inadvertently impact your responsibilities at Cook Children’s or our patients,” said Kent Smith, Vice President of Compliance. “Clear guidelines protect everyone. By keeping an open line of communication with your leadership, we can prevent burnout, ensure a safe environment for our patients, and support a culture of transparency.”

The guidelines were developed by a task force that included leadership from the Medical Centers, Cook Children’s Physician Network, Legal, Compliance and Human Resources. Task force members also sought feedback from leaders at Cook Children’s Home Health, Cook Children’s Health Plan, Payor Relations, and others, before they were finalized.

You can find the guidelines on CookNet. Go to Employee Resources, then click Employee Essentials on the dropdown. Navigate to the Organizational Resources section and click on “Outside Employment Moonlighting” button. 

What Defines "Outside Work"?

Dual or secondary employment means any work performed outside of your role with Cook Children’s. For example, this includes:

• Working with another health care provider or private practice.
• Telemedicine or consulting roles.
• Self-employment or freelance projects.
• Any other external job, regardless of the industry.

Guidelines Highlights

Employees must preserve confidentiality by not sharing Cook Children’s proprietary information, practices, documents, employee and/or patient data between employers.

Your outside work must NOT:

1. Conflict with your job duties: Your role here remains our priority. Employees must continue to meet all performance expectations, including scheduled shifts, on-call responsibilities, and other duties related to their job with Cook Children’s.
2. Use Cook Children’s resources: This includes using our equipment, facilities, or work time for external projects.
3. Result in excessive fatigue: We want you at your best! External work shouldn't impair your performance or health.
4. Compromise quality, safety or confidentiality: Patient safety is imperative. Employees must preserve confidentiality by not sharing Cook Children’s proprietary information, practices, documents, employee and/or patient data between employers.
5. Contradict our values: Any outside endeavor must align with our Promise and ethical standards.

What You Need to Do

We’ve standardized the way outside work is recorded. After meeting with your department leader, you’ll sign an acknowledgement that you have notified your supervisor of your outside work, identified the employer, and agree to stick to the guidelines. 

• Sign-Off: Both you and your leader will sign the agreement. The leader will specify that they believe the outside work will not create a conflict of interest or interfere with Cook Children’s job duties.
• Record Keeping: You’ll receive a copy for your records, and a second copy will be maintained in the department’s files.
• Annual Renewals: If your outside work situation changes, a new document must be processed to reflect those updates.

Team members who do not have a written employment contract but are enrolled with payers (where you or Cook Children’s bills for your services) must complete a Cook Children’s Employment/Moonlighting Attestation form and submit it to Payor Relations. This submission must be completed annually to stay in compliance with billing regulations.

Q and A: Outside (Dual) Employment Guidelines

Q: Who do these guidelines apply to?

A: These guidelines apply to all employees across the System, including clinical staff, non-clinical staff, physicians, and Advanced Practice Providers (APPs).

Q: Why do I need to sign a document for my outside job?

A: The written acknowledgment ensures that both you and your leader have a clear understanding of the conditions. It protects you by formalizing the approval and keeps the organization in compliance with safety and legal standards.

Q: What exactly counts as "outside work"?

A: Outside work (or dual employment) refers to any professional activity performed outside of your role here. This includes working for another health care provider, self-employment, consulting, or any other external job, even if it is not related to healthcare or your role at Cook Children’s.

Q: Do I need to tell my manager if I already have a second job?

A: Only if your second job was not already approved under the previous Conflict of Interest process. If you are currently engaged in outside work that was not previously approved, you must disclose this to your department leader immediately. You must also provide updates if your outside role, hours, or responsibilities change.

Q: Can my request for outside employment be denied?

A: Requests are evaluated to ensure they do not conflict with your duties at Cook Children’s, use System resources, or cause excessive fatigue. If the outside work is found to compromise patient safety or go against organizational values, it may not be approved.

Q: Can I use my work laptop or office for my side business?

A: No. A key requirement of these guidelines is that no System resources (including time, equipment, software, or facilities) may be used for outside employment.

Q: I am a nurse that does PRN work at another hospital. Do I have to fill out the form?

A: Yes. Please disclose all outside employment. If it meets the minimum conditions listed in the guidelines, there should be no issue getting it approved, but it is important for us to have a record of all outside employment.

Q: I have a social media channel from which I receive payment. Do I have to fill out the form?

A: Yes. Please disclose all outside employment. If it meets the minimum conditions listed in the guidelines, there should be no issue getting it approved, but it is important for us to have a record of all outside employment.