Devon Hill Associates provides healthcare mystery shopping services

In today’s world of Facebook, Yelp, online communities, forums and rating websites, there are plenty of opportunities for patients to communicate their complaints and opinions publicly about their medical experiences — both good and bad. Yet, for the most part, patients tend to reserve their feedback for family and friends, unless specifically asked.

Barriers such as…

  • Public website criteria for critiques
  • Physicians’ particular sensitivities about their reputations (e.g. requiring that patients sign agreement promising not to post comments on public sites, even though these agreements may not be enforceable), and
  • The “risks” to dissing providers publicly, or even, conceivably, being sued

can be deterrents to the public communication of patient complaints

In addition to the above barriers, there are the deterrents of time and energy. Creating an effective factual, verifiable description of your problem or complaint, searching for the appropriate website, or composing a letter to the hospital president, the physician or to the clinic manager take too much time, energy.

A Personal Story

I’ll never forget my experiences a couple of years ago when my husband had a life threatening bout with MRSA/sepsis. In an earlier blog, I mentioned a few of the particulars of our experience in the registration/triage areas of the Emergency Department before my husband was admitted to the hospital. But the story didn’t end there. Although he went on to be seen by a wonderful ED physician who suspected the seriousness of my husband’s condition, and to have excellent doctors in the hospital who put him on the road to recovery, when my husband was discharged 17 days later, late in the day, with a PIC line and orders for IV antibiotics twice a day from a home infusion provider — things fell apart. No antibiotics were delivered. No nurse was assigned by the home health provider to administer the first three IVs, or teach me how to do it. How did this happen?

Unbeknownst to us, the infusion company was confused about my husband’s unusual drug coverage and came to the erroneous conclusion that he had no coverage. As a result, the infusion company did not deliver the antibiotic that was ordered. Then the staff member responsible for verifying his insurance failed to inform the company’s care coordinator, the hospital or us about the problem before discharge. To make matters worse, the infusion company did not make arrangements with an approved home health company to provide the nurses who would manage my husband’s care or administer the first dose of antibiotics.

Faced at home with this stressful situation, the natural response of most patients and families would be to call the primary care doctor and/or return to the ER. But, it was evening, and my husband refused to go back to the hospital. Rather than fight that battle right then, I started making phone calls.

Fortunately, because of my prior experience in hospital management and some (limited) understanding about insurance coverage, I was able figure out whom to call, what questions to ask, what to say and what to demand. Nevertheless, it took an enormous effort on my part, including multiple phone calls, pleading, offering to pay cash for the medicine, and even screaming at people to persuade the infusion company’s regional manager to approve having several doses of the antibiotic delivered and to get a nurse from the home health company to our home late that night.The entire experience after discharge is a long story – way too long to relate here. And I’ve forgotten many of the specifics now. Suffice it to say that, during my husband’s recovery at home, the last thing I had time or emotional energy for was telling our story online or composing a letter to the hospital President describing what had occurred. I only told our family and friends about our experiences. As a result, the complete failure of systems and procedures was never directly communicated to the hospital’s Administration.

I did call the hospital’s Social Service Department about a week after my husband’s discharge and verbally related my story to a member of the staff. As far as I know, she did not take notes, but said she would bring my call to the attention of her team. I didn’t hear anything further from the hospital, either as a result of my meeting with a senior executive after our ED experience or after talking with Social Service.

Medical Mystery Shopping – Going Undercover

If you’ve read any of the other blogs on my website, you know that my company, Devon Hill Associates, conducts mystery shopping services specializing in the healthcare field. Medical mystery shopping, using incognito patients, provides detailed, timely patient experience feedback that helps an organization take action to

  • Enhance patient satisfaction,
  • Improve care, and
  • Enrich the patient experience.

To achieve these results, we engage skilled, experienced mystery shoppers to “go undercover” as patients. They call facilities and become “real” ED patients, inpatients, outpatients and clinic patients. They undergo registration, admission, treatment and discharge. They describe their experiences in detailed narrative accounts and questionnaires submitted to management (and staff). When all the mystery shops are completed, we analyze the feedback and provide the organization with a comprehensive report of the mystery shoppers’ collective findings.

Clearly, OUR personal medical situation could never have been played out in any mystery shopping project because mystery shoppers obviously can’t present with a MRSA infections. Nevertheless, with improvised, believable symptoms of other conditions, and sometimes with the involvement of the organization’s physician(s) — mystery shoppers uncover and report out a wealth of useful information about real patient experiences – the facts, emotions, hidden needs, sources of satisfaction and dissatisfaction, failures in processes and procedures – and make suggestions for improvement in systems and procedures.

Patient satisfaction and HCAHPS studies track and measure the status and consistency of specific performance standards, but they’re not always effective at uncovering or validating the sources of patient dissatisfaction or behavior — or at identifying what messages of caring, kindness, courtesy, respect and efficiency are being communicated by staff. That’s where mystery shopping shines.

If you have a problem area where the cause is unclear; if patients end up being re-admitted because your discharge or follow-up procedures aren’t working properly; if you need to determine if policies and procedures are being adhered to, or if you’d just like greater insight into what patients hear, think and feel when they call or become a patient in your facility, visit our website at call us at 858-456-7800 for more information.