Critical incidents in the gaming industry: Perceptions of guests and employees

During the service encounter or moment of truth the customer judges the quality of the service organization. Not all guest-employee service encounters, however, are equally important. For every organization there are probably particular. service encounters that are critical to customer satisfaction. Before they can initiate efforts to service their customers, service firms must first identify and manage critical service encounters. Using the environment of the gaming industry, this exploratory research investigated the concept of identifying and evaluating critical service encounters from the perspectives of both guests and customer-contact employees and measured the level of congruence/incongruence between the two parties involved in the service interaction. The study also examined the applicability of the critical incident classification scheme of Bitner, Booms, and Tetreault (1990) to the gaming industry the critical incident technique, slot customers and slot department employees of a major Las Vegas strip hotel/casino were interviewed using the same set of open-ended questions. Slot customers and employees were asked to recall both particularly satisfactory and dissatisfactory service events that had transpired at the study hotel/casino or another hotel/casino. Employees were asked to recall incidents in the manner in which they felt their customers perceived the incidents. The model and decision tree of Bitner, Booms, and Tetreault (1990) was used to code the recalled incidents. Two judges completed the initial round of coding, and then a third judge independently coded the incidents in order to obtain a measurement of inter-rater reliability; All of the customer and employee reported incidents were classified into major groups, categories, and subcategories. All of the major groups agreed with the classification of the Bitner, Booms and Tetreault (1990). However, two new categories and two subcategories that differed from Bitner, Booms and Tetreault emerged in this study. These new categories and subcategories appeared to be more specific to the gaming industry and were designated as response to customer requests, response to customer requests for comps, and comp service. The subcategories were related to requests for non-smoking rooms. Systems and service encounter problems identified included the unavailability of non-smoking rooms, slot machine fill, change service, and booth cashier service; The results showed that as a whole, customer-contact employees in this study demonstrated a genuine service orientation and did identify with and understand customer needs in the gaining environment. This was particularly true in the perception of dissatisfactory incidents reported by both customers and employees. The majority of satisfactory incidents customer and employee reported incidents concerned unprompted and unsolicited actions, in particular, attention paid to the customer. This finding highlights the importance of hiring service-oriented staff as well as directing training and other organizational resources towards cultivating a close customer-frontline employee relationship. The distributions of customer and employee critical incidents as compared to respective distributions found by Bitner, Booms, and Tetreault (1990) and Bitner, Booms, and Mohr (1994) suggest the need to continue to their model in terms of incident distribution in other industries

ATR-FTIR Spectroscopic Analysis of Sorption of Aqueous Analytes into Polymer Coatings Used with Guided SH-SAW Sensors

Attenuated total internal reflectance Fourier transform infrared (ATR-FTIR) spectroscopy was used for the investigation of sorption of aqueous solutions of analytes into polymer coatings. A series of simple model polymers, such as poly(dimethylsiloxane), poly(epichlorhydrin), and poly(isobutylene), and films and analytes, such as aqueous solutions of ethylbenzene, xylenes, toluene, and nitrobenzene, were used to evaluate the use of ATR-FTIR spectroscopy as a screening tool for sensor development. The ratios of integrated infrared absorption bands provided a simple and efficient method for predicting trends in partition coefficients. Responses of polymer-coated guided shear horizontal surface acoustic wave (SH-SAW) sensor platforms to the series of analytes, using polymer coatings with similar viscoelastic properties, were consistent with ATR-FTIR predictions. Guided SH-SAW sensor responses were linear in all cases with respect to analyte concentration in the tested range. Comparison of ATR-FTIR data with guided SH-SAW sensor data identifies cases where mass loading is not the dominant contribution to the response of the acoustic wave sensor. ATR-FTIR spectra of nitrobenzene, coupled with computational chemistry, provided additional insight into analyte/polymer interactions

UNWED FATHERS AND FRAGILE FAMILIES

Nearly a third of all births in the United States today occur to parents who are not legally married. The proportions are even higher among poor and minority populations, 40% among Hispanics, and 70% among blacks (Ventura et al. 1995). Out-of-wedlock childbearing is occurring with increasing frequency in nearly all western industrialized countries. Indeed, the proportion of children born outside marriage is even higher in the Scandinavian countries than it is in the U.S. (McLanahan and Casper 1996). However, the U.S. is somewhat unique with respect to the involvement of unwed fathers in the lives of their children. Whereas in the western European countries, the vast majority of unmarried parents are living together when their child is born, in the U.S. only about 25% of unwed parents are cohabiting (Bumpass and Sweet 1989). At first glance, these figures would seem to suggest that American men who father children outside marriage are less attached to their children than European men. This impression is further reinforced by research which shows that a substantial proportion of never married fathers have virtually no contact with their children (McLanahan and Sandefur 1994).

Research Instruction and Resources in the Transactional Skills Classroom: Approaches to Incorporating Research Instruction into Transactional Skills Courses

Professors Lori Johnson, Jeanne Price, and Eric Franklin discuss methods of teaching legal research skills in the context of a transactional law class

Innovations in Primary Care: Implementing Clinical Care Management in Primary Care Practices

The Massachusetts Patient Centered Medical Home Initiative (MA PCMHI) is a statewide, multi-payer demonstration that seeks to transform 46 primary care practices into PCMHs. Clinical care management of high-risk patients is a key element of the PCMH and a new service for most primary care practices. Training for practices in the MA PCMHI includes the clinical care manager (CCM) role, identification/tracking of highest-risk patients, care plan development/implementation, care coordination, and communications. Content is delivered through learning collaborative sessions, monthly webinars and practice-based transformation facilitation. Assessment of progress towards implementation is made through practice-based data on clinical care management measures and self-assessment of transformation. At year one of implementation, averages for measures such as percentage of patients who received timely follow-up after hospitalizations and ED visits range 37%-63% with 35-40 of 46 practices reporting. The challenges that have hampered implementation include lack of: (1) EMR/registry functionality, (2) hospital to practice notification systems, (3) clarity of the CCM role and workflow, (4) risk stratification criteria for high-risk patients, and (5) adequate resources to support this service. An important lesson learned is that engaged leadership is critical to successful clinical care management implementation. Next steps include refinement of the practice-based self-assessment that is used as a monitoring and QI tool, and a pilot to study the coordination of payer-based and practice-based clinical care management

Implementing Integrated, Interdisciplinary Clinical Care Management in the Patient-Centered Medical Home

Clinical care management (CCM) of the highest risk, most complex, and costly patients is an integral component of the patient-centered medical home (PCMH) but a new service for many primary care practices. The Massachusetts Patient-Centered Medical Home Initiative (MA PCMHI) is a 3-year, multi-payer demonstration with 45 participating practices. Support for CCM implementation is provided through learning collaboratives and practice facilitation. Techniques for shared learning include developing a CCM interdisciplinary team workflow utilizing process mapping and modeling care plan development. MA PCMHI practices have found these techniques valuable for clarifying what a care plan is and visualizing existing workflows, so others in the practice can more clearly understand the care manager role. Presenters will utilize these techniques with audience members to advance their knowledge and skill set in implementation of practice-based care management. Presented at the Conference on Practice Improvement Society for Teachers of Family Medicine

Regulation of Serum Response Factor and Adiponectin by PPARγ Agonist Docosahexaenoic Acid

Recent studies indicate that significant health benefits involving the regulation of signaling proteins result from the consumption of omega-3 polyunsaturated fatty acids (ω-3 PUFAs). Serum response factor (SRF) is involved in transcriptional regulation of muscle growth and differentiation. SRF levels are increased in the aging heart muscle. It has not been examined whether SRF is made by adipocytes and whether SRF secretion by adipocytes is modulated by PPARγ agonist DHA. Adiponectin is made exclusively by adipocytes. We and others have previously reported that PUFAs such as DHA increase adiponectin levels and secretion in adipocytes. Here we show that DHA downregulates SRF with a simultaneous upregulation of adiponectin and that both these responses are reversible by PPARγ antagonist. Furthermore, there appears to be a direct relationship between DHA exposure and increased levels of membrane-associated high-density adiponectin, as well as lower levels of membrane-associated SRF. Thus, we find that the levels of SRF and adiponectin are inversely related in response to treatment with PPARγ agonist DHA. Decreased levels of SRF along with increase in membrane-associated adiponectin could in part mediate the health benefits of DHA

Implementing Integrated Clinical Care Management in the Patient-Centered Medical Home

Clinical Care Management (CCM) of the highest risk, most complex and costly patients is a key element of the Massachusetts Patient-Centered Medical Home Initiative (MA PCMHI), and is a new service for most primary care practices. There is much confusion about the role of the Care Manager (CM), and a lack of awareness of key foundational elements critical to successful implementation of CCM. This poster describes the shared approach to implementation of CCM in the MA PCMHI, use of care management and care coordination clinical quality measures to monitor implementation progress, and shared lessons learned in the implementation process