Some things are just hard to measure. Case in point: an agency's accessibility in terms of being free of stigma and discrimination. Unsubstantiated complaints and rumors may fly.
One way to assess agency openness is through use of "Secret Shoppers". They are sent out to gauge things like the quality of the clinic waiting room and the nature of interactions with staff. Good idea but such a program needs to be planned in partnership with agencies and put into place after secret shoppers are trained. NASTAD has created a toolkit that outlines these steps.
Addressing Stigma in Healthcare Facilities: A “Secret Shopper” Intervention covers the following:
- Communicate with service providers and the community to identify, for example, stigma and discrimination have clients faced and to get agency buy-in to the idea
- Develop objectives (e.g., what to measure, which agencies)
- Recruit and train participants on roles they can play, what questions they will ask (the toolkit includes a training agenda and worksheets to prepare secret shoppers)
- Data collection and analysis including how secret shoppers record their interactions immediately after a clinic visit to ensure accuracy of their assessments
- Dissemination of findings with determinations on what to disseminate and to what audiences