Mystery guests andsupervisionDr. Corry KetelaarsDr Samantha Adams

Epso Brussels 2013

Introduction- IGZ contracted MG in 2011-2012

- Reason: social, political pressure: unannounced visits, daily practice, surprise

- 38 MG visits nursing homes

- Evaluation by iBMG

- Purpose:Insight experiences with MGQuality, feasibility information MG for supervision

Epso Brussels 2013

Research Questions and MethodsResearch Questions What are different actors’ expectations with respect to using Mystery Guests as an

instrument for supervision of nursing home care? What are the experiences of using Mystery Guests in supervision (both in the

healthcare sector and other sectors)? What are the (pre-)conditions for further using Mystery Guests in healthcare-related

supervision in the future?

Methods Literature and Web study Document analysis

including comparison between reports Interviews (n=22)

Results (1/2)Expectations

1. Mystery Guests potentially have a better view of daily practice and better represent the patient perspective.

2. By signaling potential risks, Mystery Guests enable more efficient conduct of supervision – targeted visits.

3. De IGZ will be seen as more effective.

4. There is a need to “own” the approach.

Experiences

1. A number of practical issues stand in the way of a ‘better view’. Limited access, legal considerations, healthcare different than other sectors

2. Signals are indeed present, but often too implicit in current form of reporting. Narrative style, focus on ‘softer’ aspects of care, some information incomplete /incorrect 3. Not immediately evident during evaluation

4. Inspectors saw potential but did not yet incorporate information into supervision activities

Results (2/2)Inspectors recognize need for “fresh look” and have own methods for trying to get closer

to practice

Interest in using Mystery Guest information, under the condition that: The format fits current IGZ formats

Standardized language The information is easily accessible as part of information gathering routine The Mystery Guests are given more training/structure ahead of time

To be continuedMarch 2013: Political debate health supervision in House of ParliamentMinister asks the DHI to continue MG visitsMG trained to support supervision detecting risk factorsAfter one year evaluation MG’s

Furthermore:All inspection visits unannounced unless….Surprise elements in announced visits

Epso Brussels 2013

Epso Brussels 2013

Questions?