Is it really such a great idea? Here's another viewpoint from the editor of RN magazine. (I had to copy and paste the entire memo instead of providing a link because you need a subscription to RN to access this online):
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A worrisome practice What kind of care were the real patients getting while this was going on?
I was more than a little troubled the other day when I opened an e-mail from a reader in the Southwest who described a "secret shopper" program that her facility had recently implemented. For the uninitiated, secret shopper programs "plant" patients in a facility to assess things like wait times, staffers' interpersonal skills, and clinical processes.
Our reader had this to say:
"One of the secret shoppers recently came in to our ED. During her visit, the patient complained of chest pain, at which time the chest pain protocol was applied. The patient had ... labs drawn, urinalysis, chest X-ray, [and an] EKG.
"This patient was seen by the ED physician, a consulting cardiologist, an ED nurse, an ED tech, and the director of the ED, who came in to deal with her complaints.
"This patient pulled her arm away during the IV start, refused certain medications, demanded a phone [so] she could call long distance at her bedside ... and was verbally abusive to the staff. This patient took up an ED bed for five hours, then was transferred to the CCU where she soon signed out against medical advice.
"There have been several secret shopper patients that have visited our facility and we as a staff have strongly objected to the entire program. The nurses at our facility are very upset and would like to have our voices heard."
The nurse then asked for my thoughts on the situation. In a word, I was appalled.
A thousand questions rushed through my mind as I read her e-mail: What kind of care were the real patients getting while the secret shopper was getting all of this attention? What would have happened if a nurse had been injured during the failed IV start? Who is paying for the time and materials wasted on this patient? What if the secret shopper had been injured? And most importantly, why did the facility take this particular approach to assess patient care? Why not shadow a patient, pull charts, or revamp patient satisfaction surveys?
I think the nurse who wrote to me—and her colleagues—need to speak up on this issue in a loud and unified voice. They need to raise questions like the ones that immediately came to my mind. They need to raise them with their supervisors, their risk manager, and the hospital's executives. And they need to suggest alternative ways to assess patient care in their facility.
I'll keep you posted on how this story unfolds. In the meantime, I'd like to hear from you. Does your facility use secret shoppers, and if so, to what extent? E-mail me and let me know.
If this is an isolated story, I'll let out a sigh of relief. If it's not, then more than just a few nurses in the Southwest have something to worry about.
mostrowski@advanstar.com
Marya Ostrowski, ed. Marya Ostrowski.
Editor's Memo: A worrisome practice.
RN Aug. 1, 2004;67:9.
Published in RN Magazine. Copyright © 2004 Advanstar Medical Economics Healthcare Communications at Montvale, NJ 07645-1742. All rights reserved.
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Doesn't sound like such a great idea to me.
"undercover" patients in New Mexico
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