Mystery shoppers an issue in EDs?

[fireflymedic]

Mystery shoppers in the ER and EMS? Is that what you call my BS patients? When I worked in a trauma center, things weren't neccessarily better than in the smaller hospitals, larger volume, bigger problems, along with the little ones, and the county jails to deal with. None of which were fun. They treated us well for the hell they gave us, but I wouldn't dare do it again (my boss left). Plus had to babysit student docs, medic and nursing students to boot and always the patients and put up with all of their mouths to go with 'em. I think mystery patients are a waste of energy and money on everyone's part. There was one hospital near here that used to put the 'average' wait times for certain things ie lab tests, ct scans, x rays, whatever. They kept to those pretty well. They also went out of business...enough said?

[Just Plain Ruff]

I have to consider myself the ultimate in mystery shoppers.

I have worked on automating 15 or so hospitals in as many states. I have worked thru processes, worked thru workflow and many other issues and I have to say, there is 1 million different ways to skin a cat.

The bottlenecks that I consistently see are the triage process, the registration process, the ambulances bringing patients into the ER and the discharge process. A large list that is not easily remedied.

Yes consultants can come in and say, make this change or make that change but in the end if that change does not fit the workflow of the ER then those dollars spent on those consultants amount to dollars wasted.

You can say, move patients this way or flow them that way but if the ER's processes or workflow does not fit that suggestion then it won't work no matter how much money you shovel out.

When you have an ER that see's 250 patients a day and 80-90 of those patients are brought in by ambulance, many times 10 at a time there is nothing that will make the flow of patients go smoother. No matter what anyone says, it just will not go smoother.

When you have a waiting room of 100 people which during the busy time often occurs there is often the feeling of intense frustration that patient's who have been waiting for nearly 8 hours continually see patients who have been there for 3 hours going in quicker than them. This results in the most frequent complaint to nurses, administrators and doctors.

Let's take one of my hospitals that I worked at out of Miami. Average patient wait time to see a doctor for a generic medical complaint is a 8 - 12 hour wait and then 2-8 hours in the ER bed and if you need to be admitted you can expect to be there an entire day.

I can actually attest to this because I was the patient above. I spent 4 hours waiting for triage, another 4 hours after triage to go in a room. I then spent 4 hours in the room waiting for the ER Doc and then an additional 8 hours for treatment, labs, x-rays and medications and then another 3 hours waiting for the doc to discharge me. I was working at that time so I had plenty to do, thank goodness for laptops and electrical outlets and wireless. As a matter of fact I got more work done that time spent waiting than I did for the rest of the week.

I know the processes to go in the ER and get in and out so I knew that I was just a number.

I could go on and on with experiences (no others as patients) but I spend time working very very closely with ER staff's and I hear the issues that they have. Process issues, workflow issues, patient issues and many other issues.

To think this is an easy fix is naivity at it's best. There is no easy fix and to throw more money at this problem will not make it go away.

One thing that could be tried is to begin educating on when to call 911 when people are in grade school. EMS agencies and hospitals could do outreaches to pre-schools, grade schools and middle/high schools and begin to educate them as to when to call 911 and when to go to the ER instead of their doctor.

Educate the public early and often. That would be one suggestion from a highly paid consultant.

There is a saying in the consulting world, "If you are not part of the solution, there is plenty of money to be made in prolonging the problem."

[Kiwiology]

I was in ED the other day - its the same story, lack of beds and lack of staff. Some mystery QI/PR suit doesn't need to tell me that.

I can see this going down the gurgler when somebody dies in chairs because some jagoff mystery shopper was occupying a bed with a fake illness.

See, "mystery shopper" implies that a nice, friendly, joyus customer satisfying occasion is to be had at the emergency department, yeah right.

As the Horse on Ren & Stimpy said "no sir I dont like it!"

[Classair]

We need to send Barbara Gerber a link to this forum, she might find some of our reply’s to the mystery sicko interesting. And if she shows up at my ED I will apologize for the missed sticks!

Barbara Gerber President

Devon Hill Associates

San Diego, CA.

E-mail: Barbara@devonhillassociates.com.

[iMac]

ok, this has disaster written all over it, mystery shoppers in the ED.

First off, you have people posing as patients when there is nothing wrong with them. They then tie up a bed that someone could use in order to critique the staff and docs.

I would be pretty upset if I'm taking care of a mystery shopper when I could be taking care of someone who is really sick.

Talk about a waste of resources

Plus, what happens with all the patient information that the mystery shopper hears, they are no way involved in patient care and they hear confidential patient info. Isn't that some sort of hipaa or pseudo hipaa violation?

But the wastage of resources that could be used better elsewhere is what gets me

I fully agree with Ruffs. Our system here is already so overwhelmer and the staff over worked and everything is stretching at the seams. Tho I agree with Ruffs that it would tie beds that are already lacking, a handful of "mystery shoppers" wouldn't really make a big difference. They arent talking about dozens of people here, just 1-2 at a time? but still really goes against what the system is build for.

I am sure there are ways around doing this without having fakers come in to evaluate how the system is currently working.