Can mystery patients evaluate the quality of cervical cancer screenings? A pilot study in Bolivia

Objective This pilot study assesses the feasibility of using mystery patients to evaluate cervical cancer screenings provided to women in rural Bolivia. Methods We developed a protocol with local officials and adapted and pre-tested a debriefing tool. Eight mystery patients with existing appointments at four purposively selected rural facilities were recruited and trained. An interviewer debriefed patients after their screenings, and entered responses into a spreadsheet for analysis. Ques- tionnaire response frequencies and missing observations were presented. Results All patients completed screening and debriefing. On average, 93% of the questions were completed, with non-responses largely due to questions that were irrelevant to the screening venue. Responses revealed problems with confidentiality and dignity, minimal exam explanations or health education, inconsistencies across health facilities in Papanicolaou test availability, and problems in delivering and receiving test results. Conclusion Our findings suggest that the mystery patient method can be useful in evaluating the quality of cervical cancer screening and the delivery of test results in rural Bolivia.