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Healthcare Mystery Shopping – Who, What, Where and Why

Who Provides Healthcare Mystery Shopping?
There are countless mystery shopping companies worldwide; approximately 250 are members of The Mystery Shopping Providers Association. To become a member you must be in business a minimum of two years and uphold a solid reputation in the industry. References are verified and members adhere to a strict code of ethics.

There are a small number of members that specialize in healthcare and understand the intricacies of the industry. If a healthcare organization or facility is considering a mystery shopping program, it is highly recommended they hire a company that has extensive experience in healthcare; ask how many healthcare shops they have conducted and for whom. Ask what percentage of their business is dedicated to the healthcare industry. Check references and listen for language that will assure they have a complete understanding of the healthcare industry. There is a vast difference between mystery shopping for the retail industry and healthcare or long term care.

Specialized companies recruit and train experienced mystery shoppers to be their “secret/mystery patients”. They are trained specific to healthcare with an understanding of the HIPAA Privacy Rule and the specific needs of the given client and their specialty. Ask who has access to the evaluations; are they stored securely? Shoppers should be asked to sign a confidentiality agreement and a release of liability. The MSPA offers certification for shoppers which assures quality observation and writing skills.
What is Evaluated and Reported?
Healthcare mystery shopping is in place to measure and improve the patient experience thereby increasing patient satisfaction. Mystery shopping examines the patients’ perception of the providers’ interpersonal skills, the organizations policies and procedures and the overall atmosphere of the facility. Medical Mystery Shopping is not about judging clinical skills. The information gathered should be used strictly for training, encouraging and rewarding providers and staff. An experienced healthcare mystery shopping company provides detailed evaluations and a comprehensive narrative of the shopper experience. They may also provide a report based on the combined findings of multiple locations. Medical Mystery Shopping companies will not displace an actual patient in an emergent situation nor will they endanger the shoppers with invasion tests or procedures. They are also sensitive to the value of the providers’ time and will perform evaluations in a manner that will be cost effective for the provider and or organization. An organization or practitioner may use one or a combination of the different types of mystery shops available, these include:

The Complete Patient Experience: This is the most comprehensive evaluation. It begins with the phone call to schedule an appointment, front office staff, clinical staff and doctors’ interpersonal skills, wait times, compliance with policy and procedure and facility ambience, exterior and interior. The mystery patient presents with a non-emergent complaint or a new patient consultation. An experienced Healthcare Mystery Shopping Company will create believable scenarios, will never involve insurance and understands the process of referrals for specialty practices.

The Walk-In Visit: Mystery shoppers visit the facility and interact with the front office staff or registration. The mystery shopper does not see clinical staff. They are prepared with a believable scenario strictly protecting their identity. Their observations will include the reception staff response time, interpersonal skills, procedure and policy knowledge, first available appointments and facility ambience, exterior and interior.

Telephone Mystery Shopping: Mystery shoppers call a facility to access the patients’ initial, most important first impression. They evaluate phone etiquette, hold times, automated systems, scheduling, compliance with policies, scripting and procedures. Phone Mystery Shopping determines the number of potential new patients/clients a facility may be losing. It is an extremely helpful tool for train. If a client requests, the calls are recorded.

Patient Interviews: Patient interviews may be conducted as part of an ongoing mystery shopping program. With prior written consent, a representative will call the actual patient of record at different intervals of their treatment. In some instances the patients are given the evaluation tool to review before their visit so they are prepared for the call. For the patient, it is simply a phone call; the information is presented in a professional manner to the client. Generally the patients identity is strictly protected understanding the patient may develop a relationship with their provider; this allows for a completely candid interview.

Nursing Home Mystery Shopping and Assisted Living Community Visits: These are made unannounced at varying times by the mystery shoppers. The mystery shopper will present as a family member of a loved one in need of care. They tour the facility and evaluate staff interpersonal skills resident care and overall appearance of the building.
Where is Medical Mystery Shopping Performed?
There are a multitude of healthcare providers that see the value and need for mystery shopping. Fee for service or cash driven practitioners and organization are amongst the extensive list; these would include plastic surgeons, optometrists and ophthalmologists, dentists, med-spas and more. Other providers that use mystery shopping include hospitals, managed care groups, insurance providers, individual and group practices, practice management consultants, medical marketing firms, healthcare manufacturers, nursing homes and assisted living communities.
Why Do Organizations and Practitioners Use Healthcare Mystery Shopping?
While patient surveys are an excellent means to gather patient feedback they may tend to be one sided and not always accurate. The combination of patient surveys and mystery shopping is used frequently to obtain the information necessary to increase patient satisfaction. These valuable tools identify service opportunities and highlight training needs.

Mystery shoppers recall their total experience in an unemotional, unbiased, accurate manner. They are experts at remembering and recording the information they are asked to provide. They thoroughly review the evaluation form and shop guidelines before placing a call or visiting a facility.

Mystery shopping has proven to increase patient satisfaction scores, patient retention, referrals, treatment acceptance and reduce staff turnover. There is small percentage of staff and doctors opposed to the process and my thoughts are they may not have been informed it was happening making the process feel covert. Presenting the project and how the information gathered is used is essential to the success of the project. It has been my experience, when informed, staff, doctors and all employees are proud to be part of an organization that strives to provide the best possible patient care.