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news, views & ideas from the leader in healthcare satisfaction measurement

The Magic of Mystery Shopping

By Diane Peterson, FACHE, and Nancy Peacock Jensen - Edited by Terry Grundy

Ever wished you had a magic cloak of invisibility? Have you imagined flinging that cloak over your shoulders and walking the hallways of your organisation? Have you dreamt of seeing what your customer experiences firsthand? You have a wealth of valuable data about your patients’ perceptions, courtesy of the reports you receive from patient satisfaction surveying. But perhaps you dream of just a little more — a little icing on the cake, if you will. Wouldn’t a magic cloak of invisibility be handy to allow you to wander through your organisation unnoticed? Interesting thought, but not very doable. There is a practical alternative, however — a time-honoured technique used in many industries. It’s called “mystery shopping,” and it is something you can do in your own organisation. Definition: Mystery shopping is a process through which professionals pose as customers to test the service they receive in your organisation. The result is a detailed snapshot from the customer point of view. While used by hotels, restaurants, airlines and other industries for years, mystery shopping in hospitals began within the past ten years, and has proven to be a very effective tool.

The Pros There are both pros and cons when it comes to mystery shopping. The pro argument is that it provides an informed view of your organisation by a knowledgeable outsider. The mystery shopper tests many factors within the categories of access, behaviour, facilities and systems. Because they understand processes and issues from both a provider and receiver viewpoint, they can provide an objective appraisal of the experiences of a customer as they progress through a complex system of care. Some of the things you have taken for granted over the years become startlingly eyes of a customer. When employees hear the mystery shopper’s report, heads nod and they often hurry to fix problems. Survey results do not necessarily evoke similar enthusiasm. …and the Cons On the other hand, the mystery shopping report is a snapshot of one point in time. It does not cover all services, especially some of those behind the scenes. It entails only external customers’ views — e.g., patient, visitor, caller, family member. It cannot assess the views of the internal customer — e.g.,

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doctor, employee, volunteer. Finally,it can be perceived by some as “spying,”so a policy or publication about the useof mystery shoppers may be warranted.

Where to ShopThe possibilities for mystery shoppingare nearly endless.

• Acute care services• Outpatients• Doctor practices• Mental health services• Long-term care• Rehabilitation• Community Health• Home health• Information services• Any location serving

customers

How to ShopThere are basic steps to mystery shop-ping:1. Set Objectives. Decide where you

want to shop, what you want tomeasure, and how the results willbe used.

2. Choose the Type. Decide whattype of customer you want to be.Will it be as a telephone caller look-ing for information? Or as a visi-tor/family member entering thefacility for the first time? Do youwant to see what an outpatient seesor an inpatient?

3. Make Arrangements. If you planeither inpatient or outpatientassessments, you will need thecooperation of one member of yourmedical staff to write orders. Youalso need to find a shopper who canbe a good observer, be demanding,be bias-free, be knowledgeableabout health care and be a goodactor!

Then Shop. Theshopper needsdirection as to theareas to shop andmust record obser-vations as oftenas possible tokeep anaccuraterecord.

What toShopMysteryshoppersshould test allfour areas ofaccess, behaviour,facilities and systems.1. Access. How easy is it to get to,

and find your way around, yourfacility? Can you actually reachlocations by only following existingsigns? When you call, can youspeak to a real live human being ormust you navigate the interminablemenu of automated choices? Arethe hours of operation for servicesconvenient for the majority of cus-tomer users?

How is lighting and security?Would you feel safe coming here atnight? Is parking convenient or arethe best spaces saved for doctorsclergy and others? What canbe learned about your organisationby reading the Yellow Pages?

2. Behaviour. Does anyone seem tocare that you are a customer oftheir organisation? Are you made tofeel like an intelligent, adult humanbeing? Or do you feel like a roomnumber (“234, bed B”), a condition(“the gallbladder in 234”) or a pro-cedure (“the chest X-ray in Room2”)?

When you ask for somethingunusual, how is your requestreceived? Do you get an automatic“That’s not my job” or an “I don’tknow, but let me find someone whodoes?” Do the people you meetmake eye contact, acknowledgeyour presence and ask if they canhelp? Are they wearing name tagsthat you can read?

As you walk through hallways, rideelevators and sit in waiting rooms,what do you hear? Is confidentialinformation discussed in your pres-ence? Is there a lot of griping andcomplaining going on amongemployees?

As an inpatient, is your privacyrespected? Do caregivers acknowl-edge your pain, fear and lack ofknowledge? Do they really listen towhat you have to say? Do theyexplain what they are going to dobefore acting? How long does ittake someone to answer your callbutton during shift change?

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nique which motivates employees todeliver great customer service istruly magical.

3. Facilities. What’s the “am-biance” of the facility — is it ahealth care factory or a comfort-able, inviting place to regainone’s health? If the restrooms onthe first floor are dirty and lit-tered, how clean can the ORs be?Once you get past the well-deco-rated lobby, what does the“back of the house” looklike? How often are bedlinens changed?

Are bathrooms stockedwith real, cloth towelsor are they availableon request only? Areall of the electronicsin a patient room func-tioning — e.g., televi-sion, call button, bedcontrol? Is this a placeyou could feel comfort-able spending time, ifneed be?

4. Systems. Are the sys-tems established forproviding care customer-friendly or are they set up forthe caregiver’s convenience? Areyou asked to sign forms, but notread them? Is printed informa-tion readily available? Howamenable is the organisation tomaking exceptions to policies inunusual situations?

Is patient registration centralisedor decentralised? Do depart-ments coordinate their schedul-ing or is your RespiratoryTherapy appointment canceledbecause you were down inRadiology and not in your roomwhen the transporter came foryou? How long does it take to geta response to a question or complaint ?

Making Use of ResultsWhen the mystery shopper’s job isdone and the report presented, it istime to decide how the findings willbe used. The results must be present-ed in a positive manner. In any organi-sation, the shopper will find positiveaspects that are as important to high-light as the negative ones.1. Confirm Findings. Ride a

wheelchair or gurney throughthe hallways staring at the ceilingor walls. Sit in a waiting room.Spend a night in a patient room.Wear a patient gown for a day!Mystery shop a competitor’sfacility yourself.

Celebrate Success. Based onthe findings, reward loudly inpublic (and correct quietly in pri-vate). Celebrate heroes often andin imaginative ways. Also cele-brate innovative solutions.

Fix Problems. Fix obviousproblems quickly and with fan-fare. Encourage employees toseek solutions individually andwithin departments cooperative-ly.

4. Follow Up. Continuously moni-tor the correction process. Sethigh expectations — that goodservice is expected and poor ser-vice will not be tolerated. Plan onchanging the culture by example,not by mandate.

That Touch of MagicThat magic cloak of invisibility maynot be available, but the next bestthing — mystery shopping — is. Itprovides a valuable supplement toany survey's quantitative data inassessing the customer service cul-ture of your organisation. And a tech-

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Diane Peterson is president and Nancy Peacock Jensen is a senior consultant of D. Peterson & Associates, a health care consulting firm specialising in customer service management, strategic planning, and marketing. D. Peterson & Associates is a Press Ganey Quality Collaborator, working with clients to help better utilise patient satisfaction data. Diane and Nancy developed “Service Strategy: The Key to Quality,” a multi-faceted program for enhancing customer satisfaction that has been in constant use since 1987. They and their colleagues have conducted many hundreds of mystery shopping assignments.

Also Available:

"Sample Mystery Shopper's Report Card"

Contact a Press Ganey Representative at:

info@pressganey.com.au