Patients answer patient satisfaction survey questions based on their perception, yet the context is limited for the healthcare provider. This begs the questions – who were they interacting with, what was said, when did it happen, and how able and reliable was the patient to make these interpretations? So instead of convening a committee to explore the reasons for poor scores, healthcare mystery shopping provides healthcare customers with the research information needed to make real-time improvements.
In an era of value-based, hospital-stay-driven purchases, I have estimated that over 80% of the lives impacted by healthcare systems in this country are not patients at all, but rather members of family, visitors, outpatients and consumers of everything. equipment at Starbucks. By all means, make the patient room environment as clean and quiet as possible, communicate effectively with the patient and ensure they are fully prepared to go out, but the focus should always be on perception of the patient. Consumer observations, opinions and ultimately decisions flow from this source.
The high importance of patient satisfaction data means that as the data is digested, more and more questions will arise. For example, a survey will tell you that there is a problem with the friendliness of radiology staff. Instead of creating a generalized customer service program for the radiology department, the next logical step is to determine how the service is perceived by end users, what the behavioral weaknesses of the department are, and who among the staff exhibits these behaviours.
Together, patient satisfaction data and healthcare mystery shopping can begin to focus on meaningful solutions that lead providers to say, “We know from patient satisfaction that there is a problem.” and thanks to mystery shopping, we know what this problem is and who is mainly responsible.
Although managers are recommended to seek out coaching opportunities by observing their employees in action, they are less likely to expect them to change the service culture because – for the most part – they have created Culture. Since this type of research focuses strictly on consumer perception, it provides an unbiased view of the culture of a service or organization. This gives managers a third-party perspective which increases coaching opportunities.
Types of mystery shopping in healthcare
Since those early days of mystery shopping in healthcare, requests from healthcare providers have become more creative, more targeted and more sophisticated. For example, a customer may request something as comprehensive as a 24-hour hospital stay where the buyer is admitted for a 24-hour period to assess the patient experience from enrollment to discharge. . Or buyers may be asked to call medical practices to schedule appointments to determine how long it will be before they can be seen linking research to more efficient use of resources.
In 2008, mystery shopping in healthcare received significant national press when the American Medical Association attempted to take a stand on the practice. What was not so easily reported was the fact that the question was filed indefinitely. In fact, it was already the custom of one of the major vendors (before the accusation that mystery shopping for healthcare was unnecessarily consuming the doctor’s time) to use what they call process observations . This form of mystery shopping, which is most effective in emergency departments, avoids wasting valuable patient time by asking a shopper to join a patient as a friend throughout the patient experience.
Two of the most beneficial types of perception research are: 1) shopping the competition and 2) evaluating employees individually. Call it spying, many do, but it’s important to know your competitors’ culture. For example, what do they believe in and how is this conveyed to the patient, and can the anecdotal stories you have heard be verified?
Much of the value can be derived from completing individual employee reviews. For a number of reasons – cost certainly being a factor – it works best in a departmental environment and gives managers an apples-to-apples comparison of each employee as it relates to specific standards, i.e., is Cindy more likely than Jeff to see patients immediately (setting up a coaching opportunity for Jeff)? Or, is Jeff doing a great job of cross-selling and should he be commended?
Healthcare mystery shopping also gives managers real-world examples of the specific behavior that “excites patients.” This creates the perfect opportunity to introduce staff to the behaviors the organization would like to emulate while praising the employee who displays them.
Quantitative and qualitative appeal
Healthcare mystery shopping appeals to managers and administrators, whether left-brained (numbers-driven) or right-minded (story-driven). On the one hand, mystery shopping is about telling stories. Fred Lee wrote in If Disney Ran Your Hospital, “What seems to be a major component of loyalty and dissatisfaction is stories. A satisfied person doesn’t have a story to tell.” Stories are important for articulating the who, what, when, where and how of the patient or consumer experience. The right-brain approach to mystery shopping allows customers to clearly discern the difference between a completely satisfying experience and all the facets associated with it, and the elements of an experience that have triggered dissatisfaction or frustration. At the same time, mystery shopping in healthcare is an effective compliance tool. Healthcare industry-specific, and therefore benchmarkable, standards are blended with organization-specific standards to create a quantitative amalgam that can be spliced in any way necessary. Mystery shopping in healthcare primarily answers the following question: How well does your organization perform when it comes to the behaviors and processes that you have said your employees are important to? Additionally, it allows organizations to measure these standards against perception-based goals.
The flexibility of mystery shopping in healthcare
Patient satisfaction surveys are, for the most part, static. They are immutable for a reason. Conversely, mystery shopping in healthcare is much more flexible. It can be designed as a program that measures the same standards or processes over time, or studies can be developed to determine exactly which behaviors or processes are being performed.
Healthcare mystery shopping can also be redirected “on the fly” if desired goals are not achieved. For example, to their surprise, a doctor’s office that asked buyers to make appointments found that it was not accepting new patients. Another practice that was evaluating their registrars’ customer service found that none of the calls were answered by a “live” person. In both cases, the practice held back until it could fix the problem. A hospital asked shoppers to go to their website to search for specific information and then ask for a response. This revealed that requests were piling up on a PC that was not being used. This discovery allowed the hospital to avoid upsetting hundreds of consumers who felt grossly ignored.
How do you know if a service initiative is really working? Health mystery shopping is a great addition to any service initiative. It can be directed to provide real-time verification of the initiative’s effectiveness. Everything from a discharge process to a valet service can be purchased at different times to ensure that the message of the initiative has been received and implemented.
The flexibility does not extend to internal programs, however. Sometimes, in the name of saving money, healthcare providers launch a do-it-yourself program. They attempt to get employees or volunteers to perform the same function as professional health mystery shopping companies. This rarely, if ever, works for any length of time for obvious reasons. Insiders have internal biases and, despite their best intentions, are no longer able to be objective. The other reason this isn’t effective is that employees (and even volunteers) can think of a million things they should or would rather do. And the lack of stamina for a DIY program puts a huge burden on the manager responsible for administering the task.
What customers are looking for
Hospitals, health systems, and medical practices seek healthcare mystery sellers for a number of reasons. In some cases, they want to validate the “good news”. For example, a healthcare system customer entered into a long-term relationship with the primary goal of proving that their services were superior to those of the competition that they also purchased. A recent orientation study of more than 300 “stores” conducted for a major East Coast hospital found that less than 76% of their employees received a five-point rating for greeting consumers with a smile. This finding was indicative of a culture that did not treat consumers in a “personal and memorable way.” However, mystery shopping in healthcare has given them the advantage of validating their initial concern, isolating where that concern is most prevalent, and using shopper language to explain to staff why to greet people was of crucial importance for the overall perception. Like satisfaction surveys, mystery shopping in healthcare can track improvement over time, but with the added benefit of telling stories to identify problems. It can also help determine the specific nature of the problem and identify weak points.
A healthcare mystery shopping executive undergoing therapy for breast cancer recently wrote in a blog: “What matters to healthcare organizations are things like the number of steps to register a patient, scripted greetings for frontline employees, record keeping for proper billing, and clinical training for new safety measures. However, as a patient, I notice if the person checking me in for chemo smiles and greets me because they care, not if they say a scripted phrase. Then I notice if the nurses in the chemo area work as a team and greet me personally (they should know me after two months). But what’s most important to me is whether or not the clinical staff are aligned with my recovery goals.
While this executive may be more attuned to her environment than most patients and able to express what it means to her, the goal of any healthcare mystery shopping program is to utilizing the buyer’s keen sense of awareness and ability to effectively communicate their experiences in a clear and concise manner.