‘Mystery shoppers’ show if staff are in good form

Phone skills reflect other issues

An apparently distraught patient calls the registration desk at 2 a.m., asking how to schedule some blood work. In this particular scenario, the caller is not a prospective patient at all, but a trained telephone interviewer armed with a script and a survey form. Also known as a "mystery shopper," the caller is a researcher who poses as a patient in order to give a precise portrait of a hospital’s service quality and resulting patient satisfaction.

"Using the mystery shoppers has raised everyone’s awareness that the long-term value of service to our business is huge. So much is based on simple courtesy and human kindness. It affects all areas of satisfaction," says Chris Hyers, director of business development at Redding (CA) Specialty Hospital. The hospital used trained mystery shoppers to determine the responsiveness of its staff.

"We gather information differently, but what we find says a lot about patient satisfaction and correlates very well with traditional surveying methods," says Preston Ribnick, president of Professional Resources in South Wellfleet, MA, which trains mystery shoppers. "A great shortcoming of typical market research is that the results are not particularly useful. They rarely get down to the people on the front line. The power of satisfaction survey reports can be immense. It is all a matter of accountability."

Ribnick says there is a direct correlation between how staff members conduct themselves on the phone and how they strive to satisfy patients. "The perception of quality begins on the telephone. For most patients, a telephone call is their first impression. If an organization has good telephone service, it’s assumed that there will be good service throughout the organization."

The survey used by the mystery shoppers measures specific issues, such as:

Telephone technique. The caller notes how quickly the phone is answered and then what happens once the call is answered: whether there is an electronic or human voice, how they deal with putting people on hold (how they ask the caller to hold and for how long), how they handle transfers, and how the call is concluded.

The content of the call. Is the person who answers the call knowledgeable? Can the person offer clear explanations about costs, payment, and clinical issues such as, "I fell and my knee is swollen, should I come in?" Ribnick stresses that none of the questions is inappropriate or too difficult. "The 20 or so questions we ask cover 90% to 95% of all questions coming in each day."

Overall perception of the phone call. Was the person who answered empathetic and focused on the needs of the caller? The mystery shopper answers a clear-cut "yes" or "no" about whether he or she was satisfied with the call.

General comments. The mystery shopper notes specific impressions, such as the person who answered seeming abrupt or hurried.

The mystery shopper answers every item "yes" or "no" because, Ribnick says, "a hospital either does it or doesn’t. There’s no room for interpretation."

The mystery shopper service can cost nearly $10,000, depending on the hospital’s size and the amount of monitoring. Usually it takes four weeks to make the calls, a week to prepare the report, a week to present the report, and two weeks for the organization to discuss the results and set goals. Then the cycle begins again. Employees aren’t told when they are being evaluated, and afterward, the results are presented in a positive way.

At Redding, word got around that mystery shoppers were going to be used. "Managers are competitive. They want their departments to do well and may let the secret slip," he says, laughing. "So we just postponed the project and tried it again when everyone let their game faces down." Hyers used the leak as an opportunity to explain to staff that the intention was not to get people in trouble, but to help everyone improve. "No one was offended that we would try this method."

The results produced some surprises. "For instance, our people know their stuff from a clinical standpoint but weren’t personable toward patients. They were especially reluctant to talk about payment issues." Hyers also learned that the staff had problems with the telephone equipment, and in some cases, couldn’t even transfer a call.

In response, Redding plans for all employees to enroll in professional phone training from the local telephone company. To ease employee discomfort with monetary issues, Hyers has asked the hospital’s business office to coach staff on protocols involving payment questions. "The key," says Hyers, "is having standards of behavior across the house."