Secret Shoppers

I CAN: Measure adherence to infection control practices.

You’re observing and tracking infection control practices because your center’s leadership know you have an eye for detail and knack for data.

The data you collect are part of a feedback loop that expands the infection preventionist’s understanding of daily practice and enables him/her to direct the shift coaches’ efforts to the highest priorities. If your center is participating in the CT DPH pilot project, these data are also part of the program evaluation.

Your key responsibilities are to:

You'll conduct twice weekly audits of hand hygiene, masking, and transmission-based precautions.

You and your coworkers have already completed infection control training. You can access resources to refresh your memory, but this program centers on using coaching to improve the day-to-day application of these practices.

Become familiar with the tools to familiarize yourself with the concepts you'll be observing:

Our brief 5-minute training video walks you through populating a tool and calculating adherence.

You'll be conducting audits anonymously — if you can! It may be challenging to be a "secret shopper," but try to think creatively about how to watch without staff realizing. At one of the centers in the I CAN pilot, a secret shopper conducted wheelchair inventory.

The instructions for each observation tool are similar, but not identical, so they are included on p. 2 of each tool.

At a high level, you'll randomly identify four staff members to observe for each of the three tools (12 people twice a week, for a total of 24 observations), observe each staff member as unobtrusively as possible for several minutes, and then use the tool to document what you saw. Instructions vary slightly by tool, but essentially you'll record whether or not a practice was done or not, not applicable, or not observed (for example, if your view of the staff member's action was obscured).

Each observation takes about five minutes; maybe a little longer, as you're learning what to look for and how to document your observations; maybe a little less time, once you've had practice.

Gold standard: Aim to conduct observations two times each week for each of the three topics. If you do that, we estimate that it will take about two hours a week — maybe less, if there is no one on precautions and no need to complete that tool.

Other options: Can't conduct observations two times each week? Figure out the right frequency for your center or enlist the help of additional secret shoppers to help capture data more often.

Once you've completed your observations, you can calculate and share adherence with the infection preventionist.

First, record the total number of practices that were done (number of yes responses) and the total number of observations (number of yes and no responses) for each row at far right.

Second, sum each column and divide the total number of yes responses by the total number of yes and no responses, then multiply by 100. The result is your percent adherence for that topic: hand hygiene, masking, or transmission-based precautions.

Would you rather automate that the adherence calculation? Would you like to graph results?

You can data-enter the row totals into a Microsoft Excel or Google Sheets tracking log (email to obtain a copy) that will calculate adherence for you and graph the results over time. The end of the training video (beginning 3:17) walks you through entering data into Google Sheets.

Google Sheets is similar to Excel, but "lives" online so it can be accessed by multiple members of your team without printing or emailing the file. (None of the information captured contains PHI, so emailing a file or using a web-based platform is permissible.) Note that you need a Google account to view Google Sheets; any email can be associated with a Google account, not just Gmail.

Don't have time to calculate adherence? You can share your completed paper forms with the infection preventionist.


Contact us with questions or sign up for program updates