Hospitals Use ‘Mystery Shoppers’ to Monitor Handwashing

So-called “mystery shoppers” are a growing trend in hospitals, according to an article from HealthLeaders Media, and I have mixed feelings about it.

A mystery shopper is a person, usually a hospital staff member, who secretly observes the behavior of other employees – primarily to see whether they are regularly washing their hands.

No one disputes the importance of clean hands in a hospital in reducing the spread of germs, and pretty much everyone agrees that more needs to be done to get employees to wash their hands more often.

But is this the way to go about it? My concern is that this approach may end up focusing more on what individual employees are doing, rather than on flaws that may exist in hospital processes.

The article tries to put things in a positive light, describing a program at Inova Loudoun Hospital in Leesburg, VA.

The hospital uses these hand hygiene figures to spot trends and see where problem areas exist. For example, if a particular unit has a high incidence of noncompliance, Gayle Lovato, MS, RN, an infection preventionist, looks for opportunities to perform staff education or to improve systems issues, such as making alcohol-based hand sanitizer more readily available.

But sometimes, hospital employees are not thrilled by the idea.

There are a number of barriers to overcome before starting a mystery shopper program, says Brian Hudson, MT (ASCP), CIC, an infection preventionist at Cleveland Regional Medical Center in Shelby, NC.

Cleveland Regional also users secret shoppers to monitor handwashing. His biggest challenge has been recruiting people to take the job. "Nobody wants to be thought of as a rat," he says. "It's viewed as tattling."

What are you views? Is this a good or a bad approach? Share your thoughts below.

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