Customer brand engagement during service lockdown

Purpose While the customer brand engagement (CBE) research has advanced important insight, most studies to date explore CBE under regular, free-market conditions, yielding an important knowledge gap regarding its manifestation under less regular conditions, including disaster/pandemics. This study, therefore, aims to explore CBE with essential/non-essential service during COVID-19-prompted citizen lockdown. Design/methodology/approach Based on a review, the authors develop a framework of lockdown-based CBE with essential/non-essential service interactions, which are conceptualized by their respective capacity to meet differing needs in Maslow’s hierarchy. The authors view lockdown-based essential/non-essential service interactions to differentially impact CBE, as summarized in a set of propositions. Findings The framework depicts lockdown-based essential/non-essential service interactions and their respective impact on CBE. The authors propose two essential service modes (i.e. socially distant/platform-mediated interactions) and two non-essential service modes (i.e. service closure/platform-mediated interactions), which the authors hypothesize to differently affect CBE. Moreover, the authors view the associations between our lockdown-based service modes and CBE to be moderated by customers’ regulatory focus (i.e. promotion/prevention), as formalized in the propositions. Research limitations/implications Given the authors’ focus on lockdown-based CBE, this paper adds unique insight to the literature. It also raises ample opportunities for further study, as outlined. Practical implications This study yields important managerial implications, including the suggested adoption of differing tactics/strategies to leverage promotion/prevention-focused customers’ brand engagement during lockdown. Originality/value By exploring the effects of lockdown-based essential/non-essential service modes on promotion/prevention-focused customers’ brand engagement, this paper adds novel insight.

74 Effects of Community Falls Prevention Service Closure on Ischaemic Heart Disease Attendances in Secondary Care: An Interrupted Time Series Approach

Background In 2009 we implemented a novel multidisciplinary, multifactorial falls, syncope and dizziness service model utilising proactive, primary care-based screening (≥60 years). Participants underwent comprehensive geriatric assessment, while 25% of the 4032 service participants had exercise training. All had additional lifestyle advice on exercise, alcohol intake, weight loss and smoking cessation. The preliminary outcomes of this approach have been previously reported, with occult atrial fibrillation, murmurs, ECG-evident ischaemic heart disease (IHD) etc reported to GPs for further action.1 Funding was withdrawn and the service closed on 31/01/2014. We examined IHD secondary care attendances with and without service provision. Methods Patients: North Tyneside residents ≥60 years at time of closure of the service in January 2014, who were presented acutely to secondary care with IHD using an interrupted time series method. ICD-10 coded IHD numbers were determined (Hospital Episode Statistics from 01/02/2012[date of a change in coding compared to service commencement in 2009] until 31/05/2017) including 25-months with, and 40-months without, service provision. Results The Table summarises the change in IHD +/- service provision; there was a significant reduction in IHD non-elective admissions during both time series’, but the reduction was significantly lower without service provision. In addition, immediately following the service closure there was an initial increase in IHD complications of 18.4% (p=0.059) followed by an increase in the time trend of 2.7% (p=0.029), resulting in a 0.6% post-service monthly reduction in IHD complications. Conclusions Disinvestment in this service resulted in a slowdown in the underlying reduction of IHD diagnoses in secondary care. However, further research is needed to control for patient-level characteristics, the economic impact and to look at the effect of the service on other cardiovascular diseases. Reference 1. Parry SW. JAGS 2016; 64 (11):2368–2373.

87 Effects of Community Falls Prevention Service Closure on ICD-10 Coded Fracture Rates in Older People: An Interrupted Time Series Approach

Introduction Guidelines on falls prevention recommend case ascertainment based on opportunistic case ascertainment and referral in those who have fallen. In October 2009 we implemented a novel multidisciplinary, multifactorial falls, syncope and dizziness service with enhanced case-ascertainment through proactive, primary care-based screening for associated risk factors. In addition to comprehensive geriatric assessment, 25% of 4032 service participants underwent strength and balance training. The baseline outcomes have been previously reported.1 Funding was withdrawn, and the service closed on 31/01/2014. We examined the effect of service-closure on fractures presenting to secondary care with and without the service running. Methods An interrupted time series method was used. ICD-10 coded fracture numbers attending secondary care were determined (Hospital Episode Statistics from 01/02/2012-31/05/2017) for all North Tyneside residents ≥60 years at the time of service closure, including 25-months with, and 40-months without, service provision. Results There was a 0.9% (p=0.018) monthly reduction in falls over 25-months of service provision which increased during the winter months of a 9.8% (p=0.015) increase. In the month following the service closure there was an initial increase in fractures of 8.5% (p=0.231), followed by an increase in the monthly time trend of 1% (p=0.018). This resulted in a post-service monthly increase in fractures of 0.1%, an estimated extra 625 fractures over the 40-month post-service cessation period. At an average £8600 per fracture, the estimated cost may have been £5,375,000. Conclusions In this naturalistic experiment, following an initial drop in fractures, disinvestment in this service resulted in a rise in elders’ fractures presenting to secondary care. The closure of the service may have had a large unintended cost, averaging £1.5 million annually, versus annual running costs of £220,000. Further research is needed to control for patient-level characteristics and to establish the cost-effectiveness of the service.

Local Users, Consortial Providers: Seeking Points of Dissatisfaction with a Collaborative Virtual Reference Service

Objective – Researchers at an academic library consortium examined whether the service model, staffing choices, and policies of its chat reference service were associated with user dissatisfaction, aiming to identify areas where the collaboration is successful and areas which could be improved. Methods – The researchers examined transcripts, metadata, and survey results from 473 chat interactions originating from 13 universities between June and December 2016. Transcripts were coded for user, operator, and question type; mismatches between the chat operator and user’s institutions, and reveals of such a mismatch; how busy the shift was; proximity to the end of a shift or service closure; and reveals of such aspects of scheduling. Chi-square tests and a binary logistic regression were performed to compare variables to user dissatisfaction. Results – There were no significant relationships between user dissatisfaction and user type, question type, institutional mismatch, busy shifts, chats initiated near the end of a shift or service closure time, or reveals about aspects of scheduling. However, revealing an institutional mismatch was correlated with user dissatisfaction. Operator type was also a significant variable; users expressed less dissatisfaction with graduate student staff hired by the consortium. Conclusions – The study largely reaffirmed the consortium’s service model, staffing practices, and policies. Users are not dissatisfied with the service received from chat operators at partner institutions, or by service provided by non-librarians. Current policies for scheduling, handling shift changes, and service closure are appropriate, but best practices related to disclosing institutional mismatches may need to be changed. This exercise demonstrates that institutions can trust the consortium with their local users’ needs, and underscores the need for periodic service review.

Changes in Labor and Delivery Patterns and Outcomes after Rural Obstetrical Service Closure

The number of rural hospitals offering labor and delivery services has been declining across the United States for decades. As a part of this trend, labor and delivery services at Cook County North Shore Hospital in Grand Marais, Minnesota were discontinued in July of 2015. The closure necessitates that patients now travel to Duluth, 110 miles away, for hospital-based delivery services. Partnership between Duluth’s regional campus medical school and this rural community has grown to incorporate researching the effects of this closure on the Cook Country region including the community of Grand Marais. A prior study undertaken evaluated patients’ perspectives on this loss of local obstetrical services. This study was undertaken to better characterize the utilization and clinical outcomes of obstetrical care for patients before and after local labor and delivery services were discontinued. Retrospective chart review was done comparing measures before and after delivery services discontinued locally. Although not statistically significant, patterns since closure include an increased percentage of inductions, home births, and cesarean deliveries for women in Cook County.

Dramatising austerity: holding a story together (and why it falls apart . . .)

A group of women in the North East of England; women getting on and getting by amidst austerity. But what does austerity become for these women? How does it surface and register in their everyday lives through a series of fragmented encounters? Together, we developed a fictional play to explore how austerity acted in the midst of other things. Effects ranged from the un-dramatic to the intense – from an empty flowerbed at the end of the street to service closure and a loss of support. How then to ‘evoke’ austerity in this article and through the narrative form of a play? Does austerity become atmospheric like smog – something cold and wet settled over the place? Like a coercive character making demands she cannot meet? Or a particular pattern of relations between event and effect: a plot that falls apart? Our attempts at dramatisation revealed austerity’s fracturing and dissonance. Austerity sapped women’s energy to flourish through existing attachments to one another, to family life and to other forms of unpaid care; it made promises it couldn’t keep; it disorientated. As austerity differently met and co-constituted the lives of women, it disrupted opportunity for collective experience so that even austerity was not commonly encountered. In that context, I work through the play and the process in its development to explore what we held together and what continued to fall apart. Story then works hard in this article. It becomes a promise of momentum towards resolution, an affective mechanism that organises lives in the chaos after financial crisis, a longed-for form for a coproduced play and a theory that might make some sense of why anti-austerity imaginaries were not coherently attached to at least by women in this process.

Forensic Science Service closure jeopardizes justice

“The Government did not consider enough evidence in its decision-making… Examining the possible impacts of a decision after the decision has been made contradicts the concept of evidence informing policy.” House of Commons Science and Technology Committee report into the closure of the Forensic Science Service.

A national plan for trauma services

The reconfiguration debate has dominated the NHS over the summer with Conservative leader David Cameron promising a 'bare knuckle fight' over district general hospitals under threat from service closure. With the focus clearly on the need for service change, it is timely for the College to restate its policy on the provision of trauma care. We are calling for a critical examination of those centres currently providing trauma care and a national plan for the identification of major specialist trauma centres to provide the best care to injured patients.