Look who’s taking notes in your clinic: mystery shoppers as evaluators in sexual health services

Abstract

Objectives To test the feasibility of professional patients as a tool for sexual health service evaluation. Professional patients are paid to use services specifically for audit or evaluation purposes without disclosing their identity as evaluators.Methods Professional patients visited five large sexual health departments used by 3000 clients per week in two inner London Boroughs with very high rates of sexual ill health. They recorded their experience on a structured evaluation form. Semi-structured telephone interviews were completed with seven service providers to document their experience of the programme.Results Recruitment and training for professional patients is described. Forty professional patients made 105 visits during two rounds of visits 9 months apart. After 47% (round 1) and 62% (round 2) of visits, the professional patients felt that they would recommend the service to a friend. The professional patients provided detailed and specific feedback on all aspects of service provision. This information was highly valued by service providers who reported few objections from staff to the visits. A small number of examples of very poor care were documented.Conclusions Professional patients are a useful tool for sexual health service evaluation. They provide high quality feedback because they are both ÔexpertsÕ on sexual health service provision and users of sexual health services. This method of evaluation raises ethical issues about the acceptability of deception as part of the evaluation process, the right of staff to anonymity and to refuse to be visited. Professional patient programmes provide an opportunity for regular cycles of user feedback to monitor quality improvement.

A systematic review of the use of adolescent mystery clients in assessing the adolescent friendliness of health services in high, middle, and low-income countries

“…Adolescent MC roles in the reviewed evaluations/studies included: (I) young females seeking pregnancy prevention or contraception/emergency contraception services [13,15–18,21–26,29,30,32,34], (II) females seeking counselling on premarital sex [29,35], (III) males seeking condoms [27,29,32,36,37,44], (IV) males and females seeking information or treatment for STIs [29,35,39], (V) or HIV testing and information [20,37,42], (VI) females requesting information about menstrual and associated problems [30], and (VII) seeking counselling for unwanted pregnancy or abortion [33,35]. …”

Measuring patient satisfaction in sexually transmitted infection clinics: a systematic review

“…One study used professional patients to assess patient satisfaction 31. Forty professional patients participated in 105 visits to STI clinics over a 9-month period 31.…”

“…Forty professional patients participated in 105 visits to STI clinics over a 9-month period 31. All staff within the clinics were aware that the study was taking place but were not aware of the patients’ identity.…”

The use of mystery guests by the Dutch Health Inspectorate: Results of a pilot study in long-term intramural elderly care

“…), whereas in healthcare issues related to quality and safety are more intricately interwoven. Moreover, as Baraitser et al [31] also point out, this method of evaluation raises questions about the acceptability of deception and the right of staff to their privacy and to 'opt out'. This complexity of evaluation and the issues it raises may preclude effective use of mystery guests on this level, as well.…”