The Evolution of Healthcare Mystery Shopping

Patients answer patient satisfaction survey questions based on their perception, and yet there is limited context for the healthcare provider. It leaves one asking the questions – who were they interacting with, what was said, when did it happen, and how capable and reliable was the patient to make those interpretations? So instead of convening a committee to explore the reasons for poor scores, healthcare mystery shopping provides healthcare clients with the research intelligence needed to make real-time improvements.

In an era of value based purchasing with a focus on inpatient stays, I have estimated that over 80% of the lives touched by health systems in this country are not patients at all, but rather family members, visitors, outpatients, and consumers of everything from equipment to Starbucks. By all means make the patient room environment as clean and silent as possible, communicate effectively with the patient, and ensure that they are fully prepared to be discharged, but the emphasis must still be on the patient’s perception. Observations, opinions, and ultimately consumer decisions derive from that source.

The elevated importance of patient satisfaction data means that as the data is digested, more and more questions will arise. For instance, a survey will tell you there is a concern with the friendliness of the radiology staff. Instead of creating a broad-brush customer service program for the Radiology Department, the logical next step is to determine how the department is being perceived by end-users, what the department’s behavioral weaknesses are, and who on the staff is exhibiting those behaviors.

Together patient satisfaction data and healthcare mystery shopping can begin to focus on meaningful solutions that cause providers to say, “We know from patient satisfaction there is a problem and from mystery shopping we know what that problem is and who is primarily responsible.”

While it is recommended that managers look for coaching opportunities by observing their employees in action, expecting them to alter the service culture is less likely since – for the most part – they created the culture. Because this type of research is strictly consumer perception, it provides an unbiased view of a department or organization’s culture. This gives managers a third party perspective that increases coaching opportunities.

Types of Healthcare Mystery Shopping

From those early days of healthcare mystery shopping, healthcare provider requests have gotten more creative, more targeted, and more sophisticated. For example, a client may request something as all encompassing as a 24-hour inpatient stay in which the shopper is admitted for a 24-hour period to evaluate the patient experience from registration to discharge. Or shoppers may be asked to call physician offices to make appointments with the intent of determining how long it will be before they can be seen tying the research to more efficient use of resources.

In 2008, healthcare mystery shopping received significant national press when the American Medical Association attempted to take up a position on the practice. What was not as readily reported was the fact that the issue was tabled indefinitely. In fact, it was already the custom of one of the leading providers (prior to the accusation that healthcare mystery shopping was unnecessarily taking up physician time) to utilize what they call process observations. This form of mystery shopping, which is most effective in Emergency Departments, avoids taking up valuable patient time by having a shopper join a patient as a friend as they go through the patient experience.

Two of the most beneficial types of perception research are: 1) shopping the competition, and 2) evaluating individual employees. Call it spying, many do, but it is important to know your competition’s culture. For example, what do they believe in and how is it transferred to the patient, and can the anecdotal stories you’ve heard be verified?

A great deal of value can be derived from conducting evaluations of individual employees. For a number of reasons – cost certainly being a factor – this works best in a departmental environment and gives managers an apples-to-apples comparison of each employee as it pertains to specific standards, i.e., is Cindy more likely than Jeff to greet patients immediately (setting up a coaching opportunity for Jeff)? Or, does Jeff do a great job of cross-selling services and should be commended?

Healthcare mystery shopping also gives managers concrete examples of the specific behavior that “turns patients on.” This sets up the perfect opportunity to present to staff the behaviors the organization would like emulated while giving kudos to the employee who displays them.

Quantitative and Qualitative Appeal

Healthcare mystery shopping appeals to managers and administrators whether they are left brained (numbers focused) or right brained (narrative focused). On the one hand, mystery shopping is about story telling. Fred Lee wrote in If Disney Ran Your Hospital, “What seems to be a major component of both loyalty and dissatisfaction are stories. A satisfied person has no story to tell.” Stories are important in articulating the who, what, when, where, and how of the patient or consumer experience. The right brain approach to mystery shopping allows clients to clearly discern the difference between a completely satisfactory experience and all the various facets that went into it, and those elements of an experience that triggered displeasure or frustration. At the same time, healthcare mystery shopping is an effective compliance tool. Standards that are specific to the healthcare industry, and therefore can be benchmarked, are mixed with organizationally specific standards to create a quantitative amalgam that can be data spliced in any way necessary. Healthcare mystery shopping primarily answers the following question – How well does your organization perform on the behaviors and processes you told your people are important? In addition, it lets organizations measure those standards against perception-based goals.

The Flexibility of Healthcare Mystery Shopping

Patient satisfaction surveys are, for the most part, static. They are unchanging for a reason. Conversely, healthcare mystery shopping 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 what behaviors or processes are being performed.

Healthcare mystery shopping can also be redirected ‘on the fly’ if the desired objectives are not being met. For example, to their surprise, a physician practice that was asking shoppers to make appointments found out they weren’t accepting new patients. Another practice that was evaluating the customer service of their registrars discovered that none of the calls were being answered by a ‘live’ person. In both instances, the practice put on the brakes until they could fix the issue. One hospital was having shoppers go to their website to look for specific information and then having them request a response. What this uncovered was that the requests were accumulating on a PC that was not being used. This finding allowed the hospital to avoid upsetting hundreds of consumers who felt they were being rudely ignored.

How does one know if a service initiative is really working? Healthcare mystery shopping is an excellent complement to any service initiative. It can be directed in such a way that it provides real time verification that the initiative is being effective. Anything from a discharge process to valet service can be shopped at various times to ensure that the initiative’s message was received and implemented.

Flexibility does not, however, extend to internal programs. Sometimes in the name of saving money, healthcare providers will launch a do-it-yourself program. They attempt to get employees or volunteers to perform the same function that professional healthcare mystery shopping firms do. This rarely if ever works for any duration for obvious reasons. Insiders have internal biases and, despite their best intentions, are no longer able to be objective. The other reason this is not effective is that employees (and even volunteers) can think of a million things they should be doing or would rather be doing. And the lack of staying power for a do-it-yourself program puts a tremendous burden on the manager assigned to administer the task.

What Clients are Looking For

Hospitals, health systems and physician practices seek out healthcare mystery shopping vendors for a number of reasons. In some cases, they want to validate “good news.” For example, one health system client entered into a long-term relationship with the primary goal of proving that their services were superior to the competition that was also shopped. A recent wayfinding study of over 300 ‘shops’ conducted for a large hospital on the east coast concluded that less than 76% of their employees received a top box score of five for greeting consumers with a smile. This finding was indicative of a culture that was not treating consumers in ‘a personal and memorable way.’ However, healthcare mystery shopping afforded them the advantage of validating their original concern, isolating where this concern is most prevalent, and using the shopper’s language to convey to staff why greeting people was critically important to overall perception. Much like satisfaction surveys, healthcare mystery shopping is able to monitor improvement over time, but with the added benefit of story telling to pinpoint issues. It can also be instrumental in determining the specific nature of the concern and identifying where weaknesses exist.

A healthcare mystery shopping executive, who is undergoing therapy for breast cancer, wrote in a blog recently, “What matters to healthcare organizations are things like how many steps it takes to check a patient in, scripted greetings for frontline employees, record keeping for correct billing, and clinical training for new safety measures. However, as a patient, I notice if the person checking me in for chemo is smiling and greets me because she cares, not if she delivers a scripted sentence. Next, I notice if the nurses in the chemo area are working as a team and greet me personally (they should know me after two months). But what is most important to me is whether or not the clinical staff is aligned with my recovery goals.”

While this executive may be more attuned to her surroundings than most patients and able to articulate what it means to her, the goal for any healthcare mystery-shopping program is to use the shopper’s heightened sense of awareness and their ability to effectively communicate their experiences in a way that is clear and concise.

Healthcare Administration Degree For Rewarding Healthcare Careers

A career in healthcare has long been associated with doctors and nurses in their crisp white uniforms delivering care to patients. But there is an entire workforce that functions tirelessly, away from the glaring lights, to support these primary care givers and ensure the smooth delivery of healthcare.

Among these men and women are the healthcare administrators or managers on whose shoulders rests the responsibility of managing and running a healthcare organization.

The Department of Labor describes the day to day function of a healthcare administrator as planning, directing, coordinating, and supervising the delivery of healthcare. In other words, they are the ones who take care of the administrative and business aspects of running an organization, so the healthcare providers can do just that – provide care to the patients.

Why Healthcare?

If you are the crossroads of choosing a career, then this is as exciting a time as any to get a healthcare administration degree and enter this profession. Pages after pages have already been written about how an aging population has led to a sharp increase in the demand for healthcare professionals.

According to the Department of Labor, 10 of the 20 fastest growing occupations are related to healthcare. Now, that is a staggering figure by any measure of standards.* Healthcare administration itself is projected to grow at a faster than average pace and the employment of healthcare administrators and managers is expected to grow 16 percent by 2018.**

But excellent job opportunities and attractive compensation are not the only reasons to pursue a healthcare administration degree. The industry is also going through an exciting phase as innovate technology gets integrated with the healthcare delivery system and regulatory environment becomes more complex. The job of a healthcare administrator has become more challenging in the recent years.

Education & Training

If you thought that you need to put in six to seven years of college education to become a healthcare administrator, think again. The good news is that interested candidates can enter the profession with a bachelor’s degree in healthcare administration.

Since healthcare managers need to be familiar with management principles and practices, a bachelor in healthcare degree is designed to teach students the clinical and business aspects of managing a healthcare facility by training them in management principles, strategic planning, resource management, leadership skills, and other office procedures and medical terminology.

Graduates with a bachelor’s healthcare administration degree begin their careers as administrative assistants or assistant department heads in larger hospitals. Small hospitals or nursing facilities may hire them as department heads.

Employment Opportunities

With so many healthcare facilities springing up to provide care to an aging population, healthcare administrators may find employment in a wide range of settings. These include hospitals, clinics, office of physicians, nursing care facilities, residential care facilities, home healthcare facilities, federal healthcare facilities, community care facilities, rehabilitation centers, etc.

The Department of Labor has classified healthcare administrators as either specialists or generalists. Specialists are in charge of a specific clinical department and are called clinical managers. They are trained or experienced in the specific clinical area that they manage.

Generalists, on the other hand, manage an entire facility or a system within a facility. In large facilities, they work as assistant administrators aiding the top administrator in the running of various healthcare departments.

In smaller facilities like nursing homes or doctors’ offices, healthcare administrators are usually responsible for carrying out the day to day operations like managing personnel, handling finances, recruitment, etc.

As far as remuneration is concerned, it depends on a variety of factors such as level of responsibility and the type and size of healthcare facility. According to the Labor Department, the average annual income of a healthcare manager was $80,240 in May 2008.**

So, if you think your shoulders are strong enough to take on the responsibility of running a healthcare organization, then a career full of opportunities and personal gratification is waiting for you!

* http://www.bls.gov/oco/cg/cgs035.htm

** http://www.bls.gov/oco/ocos014.htm#earnings

Healthcare Staffing Business Opportunity: Niche Or Breakout Business?

Have you ever wondered how hospitals staff their facilities? Of course you haven’t. Hospitals have a human resource department that screens, qualifies and hires healthcare professionals that fit the facilities needs right? Well sort of. In reality most healthcare facilities are staffed using nursing registries or healthcare staffing companies. You’ve probably never heard of a healthcare staffing agency (also called a medical staffing company) but these companies provide a great service to hospitals and other acute care facilities. Staffing companies help save hospitals time and money by screening, qualifying, and paying healthcare professionals.

Often when people learn about what a healthcare staffing company does, they react by saying “wow I’ve never heard of that before. What a great niche.” However, recent events beg the question, is this really a niche business or could medical staffing be the quiet gorilla in the room of the growing healthcare industry? Obama’s healthcare reform and the aging population will drive up demand for healthcare in the United States. A core realization of an increase in demand for healthcare is the need for more healthcare professionals. However, while we are seeing the potential for large demand for nurses, nursing assistants, and allied healthcare workers, we are not seeing enough growth in these employment sectors to keep up with demand. This point bring us back to the question; is healthcare staffing a niche business or a business on the verge of breaking out into something bigger than its 8.8 billion dollar size already entails?

The answer to this question is yes. Healthcare staffing represents a great business opportunity in the growing healthcare industry. Hospitals and other care facilities will turn to staffing companies and nursing agencies as the hospitals become swamped with people taking advantage of the healthcare reform and our older population who will require more hospital visits. The demand for medical staffing will only increase as the demand for healthcare increases. Medical Staffing represents a business that is poised to become huge.

You may be wondering, “How can I take advantage of the potential in the medical staffing industry?” Healthcare staffing offers many job opportunities to people without a healthcare background. You could become a recruiter and enjoy your day recruiting and finding qualified nurses to work as your agency’s healthcare work force or you could enjoy the fast paced work of a staffer who quickly matches a hospitals needs with a qualified healthcare professional. However the great thing about this business is that with the proper training and support, most people can run their own healthcare staffing office.

A great way to get the proper training and to have the support for all the questions and concerns you may have from running your own business is to buy a healthcare staffing franchise. There are many healthcare franchises out there but only a few medical staffing franchises offer the proper training and support you need. Find a franchise opportunity whose training staff is approachable and has experience in the medical staffing industry. These veterans have experienced it all and will be able to guide you through owning your own franchise.

Healthcare Staffing is already a big industry. However, the room to grow is enormous. This business is no longer a small niche. It really is a breakout business teaming with opportunity. If you do your research you will find that healthcare staffing is the fast paced, interesting business with amazing potential that you may never even have heard of.

Careers in Healthcare Administration

The thought of a career in healthcare may conjure up images of doctors, nurses, and other direct healthcare providers rushing in their scrubs from one emergency situation to another.

While there is little doubt that these direct patient care providers are the key to healthcare delivery, many others are working behind the scenes to ensure the entire process is smooth and seamless throughout the system.

Among these healthcare professionals are health services managers, also known as healthcare executives or administrators.

Healthcare Administration: The Profession

According to the U.S. Department of Labor, the primary job of a healthcare administrator is to plan, direct, coordinate, and supervise the delivery of health services in a healthcare facility. A healthcare administrator may manage:

  • An entire healthcare facility
  • A specific clinical department
  • The medical practice of a group of physicians
  • Typically, a healthcare administration degree is required for the job. Depending on the level and type of degree they have, health services managers can find career opportunities in any of the following positions.
  • Hospital administration: The job of a hospital administrator is to make sure the hospital they manage runs smoothly and healthcare is efficiently delivered to those who need it. They coordinate day-to-day administrative activities such as creating work schedules, handling finances, maintaining records, managing inventory, etc. to ensure the business of healthcare continues uninterrupted.
  • Nursing home administration: Nursing homes are residential facilities for people who require constant nursing care. The challenges of managing a nursing home are quite different from those of managing a hospital. Part of a nursing home administrator’s duties is also to take care of the resident patients in addition to managing staff, finances, admissions, and the property itself.
  • Clinical administration: The responsibilities of a clinical administrator depend on the specific medical specialty department he or she manages. They are responsible for formulating and implementing policies for their clinical department, monitoring the quality of care provided to patients in that department, creating budgets, and preparing reports.
  • Health information management: Health information managers have the important task of maintaining and safeguarding patient information from unauthorized access. They work with the latest technologies in information management and security to handle hospital databases. It is, therefore, vital for health services managers in this field to keep themselves updated on evolving technologies.

Healthcare Administration: Training

Individuals interested in this profession are typically required to have a Bachelor’s in Healthcare Administration degree for entry-level assistant roles. Bachelor’s degree programs in health information management are also available for individuals interested in managing this aspect of healthcare.

Some employers, however, may insist on a graduate healthcare administration degree for the role of health services manager. A Master’s in Healthcare Administration degree may also be required for advancement from assistant roles to positions with more responsibility and a higher salary.

For healthcare administrators seeking advancement without having to take a sabbatical from work, an online Master’s in Health Care Administration program may be an ideal fit. An online healthcare administration degree can provide them the flexibility to continue their education and while still working full time.

Healthcare Administration: Compensation

According to the U.S. Department of Labor, the median annual income of health services managers in May 2010 was $84,270, depending on position, location and education.* Find out about more healthcare administration degrees at schools near you right now!

Sources:

* bls.gov/ooh/Management/Medical-and-health-services-managers.htm#tab-1