Mystery shoppers an issue in EDs?

[Dustdevil]

What didn't change over the two years that I did this QI project were dissatisfaction on waiting times in the waiting room, times it took for lab to get back and the time it took to get to a room when admitted.

Unfortunately those 3 dissatisfiers will NEVER change - as these are universally the major dissatisfiers in the industry.

You've got that right!

People will wait hours and hours to be seen by a doctor or ER back home. But then they get over here and expect instant service. They walk into my clinic, and if I have to send them back to their quarters for their shot records (which they are told to carry at all times), they whine and bitch about what a long hassle it is. If I am seeing another patient at the time, they groan and stomp away whining about how they don't have time to wait.

Ruff is right. It doesn't matter how fast you are. People always want it faster. And society is only getting worse with that attitude with every passing day. It's an ADD world out there. That's why people vote against funding the war a month after they voted for it. Retards.

[Ridryder 911]

Sorry, Dwayne just a sore nerve.. I spent over a year to "please management" and lost several good ER nurses because they did not get a "5" perfect score on their public over-all rating, yet these are the ones I would want taking care of me when I was sick.

What I see part of the problem is for every company that does these ratings or patient surveys are consulting firms on how to increase patient satisfaction. Of course they will always find there is a problem! That is how they make their real money....

I caught one of our non-biased surveyors calling a mother of one our nurses. Which should had been immediately excluded, then stated.."most people don't rank very high".. there were several other problems with the surveys, this included at least two other companies.

As well, many of our "frequent flyers" are quite aware of the hospital attempt to raise patient satisfaction levels and will even tell you.. "if you don't do this or that.. I will give you guys a bad rating".. so basically real problems. This has even affected some physicians. I know many groups are paying specific attention to their satisfaction ratings as well.. ans again many of the "shoppers" have attempted the "I give you a bad rating"..

What people do not understand due to increase number of patients, it is acceptable to have a 3-4 hr wait.. they predict in 2 years the waiting time will 4-6 on average.

R/r 911

[Just Plain Ruff]

These mystery shoppers are like consultants. there is a saying

"Consulting, if you are not part of the solution there is plenty of money to be made in prolonging the problem"

[Arizonaffcep]

The biggest problem I would see with this is the possibility of medication administration, along with unncessesary radiation administration. Although they of course have the right to refuse any/all procedures, will they? The radiation is potentially dangerous, especially if the "mystery shopper" gets several chest CT's a year-especially if the shopper is a woman. This greatly increases the chances of breast CA.

[Richard B the EMT]

This kind of reminds me of a plot on the ER show from a few years back. Invaded by an unannounced MCI's worth of Girl Scouts announcing their presumed ages, illnesses and injuries, a senior ER Doctor threw them all out, stating that they (the hospital and ER) could handle a real MCI, as they had a helicopter crash at the hospital only a few months previous.

In a slow hospital, perhaps the concept of a "mystery shopper/patient" makes sense, but in the overcrowded world of "large city" hospital facilities, in which I have operated from 1973, the chance to slow down the system just a bit more is largely evident, as seems to be the majority opinion of this string (as of this posting).

[mrmeaner]

This further solidifies my belief that the real money for nothing is in consulting. Most of the problems they will find in an overworked and understaffed department are due to the fact that they are overworked and understaffed, which any of the employees would have been damn happy to tell each administrator for a few grand (and probably for free). No true problems will be addressed. If you don't know how your department is running then you suck as an administrator/manager. If your company would like, I'd be willing to offer to tell them that on expensive looking paper with really pretty letterhead. PM me and I'll let them know where to send the check.

[StrchrFetchr]

^^

Not always so true. I spend a good deal of my time working as a Medic in a small, suburban ER. 8 Rooms, 5 Hall beds, and a 5 bed 'Fast Track". During the day, there's typically 6 nurses staffed. Sometimes 7. 1 for Charge, 1 for Triage, 1 for fast track, and that leaves 3-4 for a typical 8 patients at any given time. IMO, in this instance, it's too much staff and not enough output or/or flow. Just something else to help bump up those Press Ganey scores... [Anyone thinking of the commercial where they suggest throwing money at a problem to fix it?] [Not mentioned in staffing is the unit Secretary, 1 Aide in Fast Track, 1-2 in the ER, and a Medic]

/shrug

~Stretch

[TJZ]

I have to go on record as thinking this is a bad idea as well. In Madison all 3 of our hospitals are very busy most all the time. It is not uncommon to be at UW for 8 hours with a non life threat. Of course they are the trauma magnet so....

I have seen it from the patient perspective and spent many years "behind the scenes" as a custodian. There is not wasted time chattering, in fact I saw very few completed personal conversations. When I did my clinicals we did not rest the entire time. We did fluff pillows some but mostly we were working for the patients real, emerget needs.

I even did a stint entering the patient report cards into the computer and it was true, the wait is the biggest bitch. Some people just can't understand why the stroke patient went in before they did when their arm is broken and it hurts.

[Don1977]

I think thats a great idea! see how different hospitals treat different people, especially see how you are treated if you have no insurance compared to if you do, I always see people being discriminated based on there insurance or if they have it or not.

[stone13]

So what happens if these mystery shoppers are sent home with a prescription for medication? Do they fill it? Is it turned over to the company? And what about IV placement, and med administration while the "patient" is in the ED? Are there restrictions on what the "patient" can have done? The article said there were several scenarios, but were vague on the details.

I don't think it would be a completely bad thing, but I think that the patient satisfaction surveys that are sent to darn near every ED patient would be able to spot any weakness without the hospital staff having to waste resources on fake patients.

Wait times will always be a major complaint. The average patient just doesn't understand that the patient with a true respiratory emergency is going to go into a treatment area or room before the I've had a belly ache for 3 days patient. They almost all believe that it should be a first come first served basis. I worked triage for 3 years at a childrens hospital and this was always the biggest gripe from patients/parents, and I'm pretty sure we didn't need a "mystery shopper" to tell us that wait times were a problem.