Devon Hill Associates provides healthcare mystery shopping services

In the September 2013 issue of the Allegheny Medical Society Bulletin, Dr. Fred Rubin provides a first-hand account of his experience as a patient in the hospital where he works. He recalls the various tests, procedures, diagnosis and care he received in the Emergency Department and during his 14-day hospital stay.

Dr. Rubin describes the frustration of sleep-disrupting procedures and the helplessness he felt as he lost control of his body. In summarizing the “good and the bad” of his time spent as a patient, he concludes that his overall hospitalization was a “terrible experience.”

Although this likely wasn’t what hospital management wanted to hear, Dr. Rubin’s knowledge of the hospital’s policies and procedures — along with his expertise as a physician — put him in the ideal position to suggest changes to improve the patient experience.

I had a similar opportunity when my husband, a physician, needed emergency care last fall. My background as a hospital executive and a medical mystery shopper enabled me to “see” instances worth reporting to management as I sat by my husband’s side during his visit to the hospital’s Emergency Room, his 17-day hospital stay and discharge to home care. Like Dr. Rubin’s account, there were good and not so good experiences.

It began when my husband presented at ER reception and triage. In spite of the severe back pain level (a “10″) and its sudden onset — and his fear that he might be experiencing a dissecting abdominal aortic aneurysm — he was told to wait his turn. Only after my eventual strenuous insistence that he be triaged was he was finally evaluated by a nurse. He was ultimately admitted to the hospital and diagnosed with a MRSA infection and epidural abscess.

While my husband was in the hospital, I met with a representative of Administration to review my husband’s ER experience. He listened, took notes, commented on what seemed unacceptable and agreed to let me know about any steps taken to ensure other patients would not face similar problems. I did not receive the promised follow-up call. Ultimately, the ER intake and triage experience colored our overall perceptions of the hospital.

Today, there is much talk about the need to enhance patients’ perspectives of their care. Yet, it is virtually impossible to get detailed, real-time feedback from “real” patients. ER and admitted patients and their families, don’t often have the inclination, time or energy to provide management with written factual and subjective accounts of their experiences. Nor should they be expected to. In our case, once my husband came home, I was too busy administering IV antibiotics three times a day and otherwise providing care to offer feedback about the inpatient or discharge experiences.

Mystery Shopping: A Catalyst for Change

That’s why mystery shopping is so valuable. Although a mystery patient can’t present with signs and symptoms of MRSA, a dissecting aortic aneurysm or an ischemic ileum, their scenarios and complaints can be believable enough to be taken for “real” patients. They report on almost everything that happens door-to-door. Hospital management and staff learn the facts of the visit — and, what was going through the patient’s mind during each staff encounter and every interaction with hospital processes and procedures. In many cases, mystery shopping reports become the catalyst for change and improved care.

Now that some hospital reimbursement is based on patient satisfaction performance measures, mystery shopping can directly impact your hospital’s bottom line. To learn more about mystery patients and professionally written mystery shopping reports – from uncomplicated telephone scheduling calls to inpatient visits – contact Devon Hill Associates at 858-456-7800 or visit our website at