Mystery guests
and
supervision
Dr. Corry Ketelaars
Dr 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 MG
Quality, feasibility information MG for supervision
Epso Brussels 2013
Research Questions and Methods
Research 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
Experiences
1. Mystery Guests potentially have a
better view of daily practice and better
represent the patient perspective.
1. A number of practical issues stand in
the way of a ‘better view’.
 Limited access, legal considerations,
healthcare different than other sectors
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.
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 continued
March 2013: Political debate health supervision in
House of Parliament
Minister asks the DHI to continue MG visits
MG trained to support supervision detecting risk
factors
After one year evaluation MG’s
Furthermore:
All inspection visits unannounced unless….
Surprise elements in announced visits
Epso Brussels 2013
Questions?
Epso Brussels 2013