1. Mystery guests and supervision Dr. Corry Ketelaars Dr Samantha Adams Epso Brussels 2013

2. 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

3. 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)

4. 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

5. 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

6. 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

7. Questions?