Clinics: How Mystery Shopping Uncovered Dysfunctional AVR, Telephone and Scheduling Systems

Management of a system consisting of a hospital and multiple clinics had been hearing numerous complaints about long waits for appointments and discourteous, disinterested staff at their clinics. The organization decided that mystery shopping would provide the needed information from which to best validate the patients’ complaints and make improvements. They solicited several proposals and chose Devon Hill Associates to conduct the telephone mystery shopping project.

After discussing the system’s scheduling process and expectations, carefully selected mystery shoppers made calls to the clinics and to central scheduling. They logged the dates and times of their calls and their appointments. They documented whom they spoke with, how long the calls lasted, whether they reached voice mail or were transferred, and the number and length of hold times. They completed narrative accounts of their experiences and filled out detailed questionnaires that covered telephone technique, the scheduling process and how staff communicated with them. It didn’t take long to validate the “real” patients’ complaints.

Devon Hill submitted the narratives to management plus an analysis of the findings which emerged from the mystery shoppers’ various forms of feedback. We described the key problems that were identified with the telephone and AVR systems and staff behavior, including:

• confusing recorded messages;
• dropped or disconnected calls;
• calls that ended in endless loops or long waits;
• scheduling policies and/or processes that seemed to be arbitrary or unnecessary inefficient and/or inconsistently applied;
• inconsistent information.

These problems led to delays in scheduling, multiple unnecessary calls that had to be made and answered by staff, conflicting information and, ultimately, frustrated patients and employees. In addition, the mystery shopping project demonstrated that staff were not adequately trained or supervised in phone etiquette, scheduling protocols or to communicate consistently clear information about scheduling, prices and services.

As the result of Devon Hill’s report, the system made major changes to its AVR and telephone systems. Less than a year later, Devon Hill Associates was asked to make a second round of calls to some of the clinics to assess the results of these changes (Phase 2).

During phase 2, it was apparent that the AVR system had been significantly improved. The mystery shoppers did not have to make as many calls to schedule appointments. They did not have to contend with dropped or disconnected calls. There were no more calls that rang extensions that never answered and only one caller ended up in an endless loop. The AVR system now announced estimated hold times at approximately 60 – 90 second intervals so that callers were not left on hold for indefinite periods with no communication, which, in turn, made it seem that the organization was more respectful of them and their time.

But, the second round of calls also discovered that access problems remained at a couple of the clinics due to a dysfunctional scheduling system process requiring some new patients to call back month after month for their first appointment. As a result, the first appointment might be 60 or even 90+ days in the future.

It was beyond the scope of the mystery shopping project to determine if the scheduling system problems were caused by: (1) the physician group who did not always release their schedules in a timely manner; (2) schedulers who failed to carefully check for the release of the new schedules and/or for openings and cancellations; (3) scheduling protocols not being followed; (4) lack of cooperation between clinic management and the physician group; (5) management problems; or (6) some combination thereof.

However, phase 2 of the mystery shopping project made it very clear to the organization that further evaluation of the scheduling system was necessary and that clinic managers, the physician group and employees would need to work together to come up with solutions to the problems that had been identified.

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Devon Hill Associates is a mystery shopping, marketing and sales training company that focuses on the healthcare and long-term care industries. We specialize in mystery shopping for hospitals, HMOs, clinics, nursing homes, assisted living and retirement communities nationwide. Devon Hill Associates is located in La Jolla, California. For information on mystery shopping and other services, call 1-858-456-7800.