Services Marketing Ab

SERVICES MARKETING

PROF.R.MATHUR

TEXT BOOKS SERVICES MARKETING BY: Christopher Lovelock

INTRODUCTION

Services Are Deeds (perishable), Processes And Performances that creates value and benefits for the customer. Facilities, equipment, labour can be held in readiness to create the Services, the elements represent the Productive Capacity. Services are all Economic Activities: - Intangible output, - Generally consumed at the time it is produced - Adds value to, say, Convenience, Timeliness, Comfort, Health Intangibles: Repair & Maintenance

SERVICES’ DEFINITION

Services Provided by Hospitals, Hotels, Banks, Insurance, to result in Customer satisfaction. Services by companies and also manufacturers and Technology companies e.g. IBM – IT services Services Sector: Transportation, Communication, Electricity, Gas, Trade, Finance, Insurance, Hospitality, Health, Amusement, Recreation, Educational, Legal, Management, Household, Private, Government Customer Services:

Services Dominates Most of the Economies Agriculture, Forestry, Mining, Construction 8% Manufacturing 14% Government (mostly services) 13% Other Services 11%

Finance, Insurance, Real Estate 20% Wholesale and Retail Trade 16%

Transport, Utilities, Communications SERVICES 8% Busines Health s 6%

Source: Bureau of Economic Analysis, November 20 Service 5 s

Changing Structure of Employment as Economic Development Evolves Share of Employment

Agriculture Services

Industry

Time, per Capita Income

Source: IMF, 1997 6

% of GDP in INDIA

2005

61

2001

20

48

1995

26

40

1980

31 0

20

26

28

36

1970

19

32

26

38

24 40 Services

45 60 Industry

80

100

120

Agriculture 7

TANGIBILITY Services more Intangible than Manufactured Products and Manufactured Products more Tangible than Services. Fast-food Industry is “Services” but has tangible components as food and Packaging. Intangibles are produced by Service sector as well as by Manufacturing sector – Boeing provides Consulting and Forecasting services Manufacturers often have “associates” which provide allied

VALUE ADDED BY TANGIBLE VS.INTANGIBLE ELEMENTS IN GOODS AND SERVICES Tangible Elements Coffee powder Soft Drinks CD player New car Tailored Clothing Furniture Rental Fast-Food Restaurant Plumbing Repair Health Club Airline Flight Retail Banking Weather forecast

Intangible Elements

GOODS vs. SERVICES MARKETING

The most basic difference is Intangibility – Related Marketing Implications – Services cannot be Inventoried – Fluctuation in Demand. Services cannot be: - Easily Patented - Readily displayed or be easily Communicated to customers – Quality? - Assessed in Quality of Services New Services concepts can be easily copied by Competitors’ Decisions about Advertising content are challenging, as is Pricing Price Quality relationship complex

SERVICES MARKETING IMPORTANCE

Services sector is 80% of Employment and 78% of GDP. Absolute and Fastest rate of growth is in Services sector. Export of Information, Knowledge, Creativity, Technology are growing in economies worldwide. Lead in development of Service Industry was taken by Banking & Health Care services. These Service Industries continue to evolve and become more competitive. The need for effective Services Management and Marketing Strategies as manufacturing and technology industries also need to provide quality Services to

Differences Between Goods & Services

Intangible

Heterogeneo us

Simultaneous Production Perishable and Consumption 12

Differences between Goods and Services GOODS SERVICES RESULTING IMPLICATION Tangible Intangible

Services cannot be inventoried Cannot readily be displayed or communicated Pricing is difficult

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Differences between Goods and Services GOODS

SERVICES

RESULTING IMPLICATION

Production Simultaneou Customers participate in separate s and affect the transaction from Customers affect each consumptio other n Employees affect service outcome Decentralization may be essential Mass production is difficult 14

Differences between Goods and Services GOODS

SERVICES

RESULTING IMPLICATION

Standardization Variability/ Service delivery & Heterogeneous customer satisfaction depend on employees action Service quality depends upon many uncontrollable factors There is no sure knowledge that the service delivered matches what 15 was planned and promoted

Differences between Goods and Services GOODS

SERVICES RESULTING IMPLICATION

Non Perishable Perishable

It is difficult to synchronize supply and demand with services Services cannot be returned or resold

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HETEROGENEITY IN SERVICES

No two human Services Performances are alike Services delivery at different times and by different employees differ Different Customers’ demands of Services in Content and quality differ Services are heterogeneous across time, organizations and people ensuring consistent service quality is challenging Quality depends upon factors that cannot be fully controlled by Service suppliers – consumer’s articulation of needs, level of demand for the service Organization may Sub-contract certain

SERVICES PRODUCED & CONSUMED

Products – Produced Sold Consumed Services – Sold Produced & Consumed Restaurant Services Sold first, dining experience Produced and Consumed. Customer present while Service Produced, can participate in the production process Mass production of services difficult. Customer satisfaction dependent upon happenings in “Real Time” Centralization does not Produce economies of Scale – operations need to be relatively decentralized. Customers may affect the outcome of

SERVICES PERISHABLE Services Are Perishable: Cannot be Saved, Stored, Resold or returned. Services cannot be inventoried Demand forecasting, Planning and Capacity utilization are challenging decision areas Strong recovery Strategies when things go wrong to regain customer goodwill. SERVICES OPERATIONS Variability: Services can be evaluated for quality before reaching the customers, e.g. car repairs. Services consumed as produced, final services must be

SERVICES OPERATIONS Difficult Evaluation: Goods can be evaluated for Physical properties. Services may emphasize Experience properties, e.g. Taste, wear ability. Credence properties – characteristics difficult to evaluate even after consumption, customers not knowledgeable, e.g. Surgery, Technical repairs, Professional Services. Time factor: Services delivered in Real Time. Customers may be willing to pay faster service. Service Marketers should appreciate customers time constraints and priorities. Distribution Channels: Advances in

CATEGORISING SERVICE PROCESSES Marketing-relevant differences among

Services: Traditional way of Grouping Services by Industry –Transportation, Hospitality, Banking. Groupings define Core products, customer needs and satisfaction. However innovative managers must look outside their own industries for effective Strategies to adapt for their own organization. One categorization on nature of

CATEGORIZING …. …. Two categories get processedPeople Customers are the Principal Inputs: Objects e.g., Passenger Transportation, Education. In case of Objects as Inputs: automobile repair, processing of financial data. In some services, processes are tangible. In others it could be Intangible, e.g., Education, Information. Service Processes on Operational perspective, can be categorized into four broad Groups. These are based on: tangible action to people’s physical bodies or customers’ physical possessions (Products) Intangible actions to people’s minds or their

CATEGORIZING …. …..These four categories are referred to as: People Processing Product Processing Mental Stimulus processing Information processing Industries within each category share important Process related characteristics. Managers can create valued innovations by studying other industries of the same category. PEOPLE PROCESSING Services directed at themselves – Transportation, Health, Lodging, Feeding. Customers must physically enter the

POSSESSION PROCESSING Customers want Services for treatment of Physical possession, e.g., House, Pets, Computer: Customers not personally involved. Customers drop the possession at the Service Provider’s centre, explain the problem, instruct for services and pick up the serviced product. If the possession cannot be moved, the service is provided at the site. MENTAL STIMULUS PROCESSING. Services that interact with people’s minds – News, education, Information, Consultancy, Entertainment, Discourses. Services aimed at Changing people’s attitude and influence behaviour. Strong ethical standards and careful monitoring,

MENTAL STIMULUS….

Customers have to be mentally in communication with information being processed. Services like education and entertainment are often created in one place and transmitted to distant customers. (Live concert directly to group of customers?). Core content of all services in this category is Information based. Such Services can be recorded and made available subsequently or converted into a disc like a manufactured product. In People Processing, a customer can sleep through a journey and still arrive at the destination in time. In contrast a student sleeping through a lecture will not be any

INFORMATION PROCESSING

Information is the most Intangible form of Service output. Information transformed into Reports, Books, Letters, Discs are tangible. Financial and professional services as Accounting, Law, Market Research, Management Services, Medical diagnosis are highly dependent on effective collection and processing of Information. Extent of customer involvement in Mental Stimulus processing and information Services are to learn about each other’s Needs, Capabilities and Personalities. Habits and tradition define the existing service delivery system and service use patterns. Increasing use of telephones, e-

CLASSIFICATION OF SERVICES PEOPLE PROCESSING TANGIBLE ACTIONS

PASSENGER TRANSPORTATION HEALTH CARE LODGING SALONS PHYSIO THRAPY FITNESS CENTRES RESTAURANTS

MENTAL STIMULUS ACTIONS PROCESSING

PRODUCT PROCESSING FREIGHT TRANSPORTATION

REPAIR & MAINTENANCE RETAIL TRADE WAREHOUSING/STORAGE LAUNDRY/DRY CLEANING REFUELING OFFICE CLEANING

INTANGIBLE

INFORMATION PROCESSING

ADVERTISING/PR ENTERTAINMENT MANAGEMENT CONSULTING TRANSMISSION EDUCATION INFORMATION SERVICES MUSIC CONCERTS RELIGIOUS SERVICES

BANKING DATA PROCESSING DATA INSURANCE LEGAL SERVICES RESEARCH SOFTWARE CONSULTING

The Services Marketing Triangle Company (Management) Internal Marketing

External Marketing

“enabling the promise”

Employees

“setting the promise”

Interactive Marketing

Customers

“delivering the promise” Source: Adapted from Mary Jo Bitner, Christian Gronroos, and Philip Kotler

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The Services Triangle &Technology Company

Technology

Providers Source: Adapted from A. Parasuraman

Customers 29

Implications of Service Processes (1) Seeking Efficiency May Lower Satisfaction Processes determine how services are created/ delivered— process change may affect customer Satisfaction Imposing new processes on customers, especially replacing people by machines, may cause dissatisfaction

New processes that improve efficiency by cutting costs may hurt service quality Best new processes deliver benefits desired by customers – Faster – Simpler – More conveniently 30

Implications of Service Processes: (2) Designing the Service Factory People-processing services require customers to visit the “service factory,” so: Think of facility as a “stage” for service performance Design process around customer Choose convenient location Create pleasing appearance, avoid unwanted noises, smells Consider customer needs--info, parking, 31 food, toilets, etc.

Implications of Service Processes: (3) Evaluating Alternative Delivery Channels For possession-processing, mental-stimulus

processing, or information processing services, alternatives include: 1. Customers come to the service factory 2. Customers come to a retail office 3. Service employees visit customer’s home or workplace 4. Business is conducted at arm’s length through - physical channels (e.g., mail, courier service) - electronic channels (e.g., phone, fax, email, Web site)

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Capacity Implications of Service Processes: (4) Balancing Demand and Capacity When capacity to serve is limited and demand varies widely, problems arise Because service output can’t be stored: 1. If demand is high and exceeds supply, business may be lost 2. If demand is low, productive capacity is wasted Potential solutions: Manage demand

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Implications of Service Processes: (5) Applying Information Technology All services can benefit from IT, but mental-stimulus processing and information-processing services have the most to gain: Remote delivery of information-based services “anywhere, anytime” New service features through websites, email, and internet (e.g., information, reservations) 34

Implications of Service Processes: (6) Including People as Part of the Product Involvement in service delivery often entails contact with other people Managers should be concerned about employees’ appearance, social skills, technical skills Other customers may enhance or detract from service experience--need to 35 manage customer behavior

SERVICES MARKETING MIX

Strategic elements of marketing manufactured goods are: Product, Price, Place & Promotion. For Services Performance, 3 elements added: Physical Environment, Process & People. 7 P’s are interrelated decision variables. PRODUCT: Select features of Core Product – a Product or Service plus other Service elements in reference to customer requirements and other competing products. Service performance with potential to create value for customers. PLACE: Place, Time of Delivery and Methods, Channels (Physical, Electronic) used. Messaging, Internet Services delivers Information in cyberspace. Physical delivery

7 Ps …. PROMOTION: Effective Communication

Strategy: Provide Information, Features and Advantages, Persuading for action. Services promotion more in nature of Education – Benefits of service, Where and When to obtain it, How to avail the Services. Communication delivered through Direct Sales or through Media. Promotions influence Brand choice. Incentives attract customers to buy. PRICE: Price to pay for benefits of Services. Service marketers must Minimize other Expenses a customer might incur in Purchasing and Using Services, e.g., travel to service location, time, physical and mental efforts, exposure to negative sensory

7 Ps …. PHYSICAL ENVIRONMENT: Provide Tangible evidence of a firm’s Service quality. Customers impressions get impacted by Building appearance, landscaping, Interior furnishing, Equipment, Printed material, Signs and other Visuals. PROCESS: Delivery of Product Elements require Design and Implementation of Effective Processes- A method and sequence of actions in Service performance. Bad processes lead to Slow, Bureaucratic, Ineffective Service delivery, dissatisfied customers. Poor Processes make front-line staff jobs difficult, results in low

7 Ps …. PEOPLE: Services Quality is often assessed

based on customer’s interactions with front -line staff. Successful Service firms devote a lot of effort to Recruit, Train and Motivate these employees. In the 7 Ps of Services Strategy, Marketing must operate with other functions in Services business. Three management functions have Central and Interrelated Roles: Marketing, Operations and Human Resources. Marketing expert T.Levitt has remarked, “There are Industries whose Service Components are greater or lesser than other Industries. Every Industry is in Service”. R.Rust suggests “Most goods businesses

CONSUMER BEHAVIOR IN SERVICES PURCHASE PROCESS FOR SERVICES PREPURCHASE STAGE NEED INFORMATION SEARCH

EVALUATION OF SERVICE

SUPPLIERS SERVICE ENCOUNTER STAGE INITIATE SERVICE FROM SUPPLIER SERVICE DELIVERY POSTPURCHASE STAGE EVALUATION OF SERVICE PERFORMANCE FUTURE REFERENCE

PRE-PURCHASE STAGE

Decision to buy and use a service. Needs and expectations of customer will influence alternatives considered. Purchase routine and low risk, customers select Service provider quickly. First time Service requirement, of a high risk, customers spend more time to select service provider.

CONSUMER BEHAVIOR IN SERVICES PERCEIVED RISKS

Functional – Will this service deliver desired result.

Financial – Will I lose money Temporal – Time Loss, Delays Physical –Injury or Damage to Possession Psychological – Fears ( flying), Emotions (feel upset)

Social – Others’ thinking, Reaction Sensory – Unwanted sensory feelings. (comfort, smell)

SERVICE ENCOUNTER STAGE

Begins with starting the service process: placing an order, submitting an application. In high contact services, customers involved in service process. In low contact, impersonal interactions with

POST PURCHASE SERVICES EVALUATION Search Attributes: Physical goods can be evaluated before purchase. Style, colour, texture, taste, machine output are tangibles that can be tested before purchase. Apparel, automobiles, electronics, food are goods high in search attributes. Experience Attributes: To evaluate some services, customers must experience them: Can be evaluated only after purchase -entertainment, restaurants fall in the Experience Category. Information on Websites, reviews, by friends etc. may not help in evaluation. Credence Attributes: Product characteristics extremely difficult for

SERVICE POSITIONING STRATEGY How do businesses compete? “On Service” …. “Value for money”, “Service quality”, “People”, “Convenience” Speed, Quality, Extras to core service Convenient Location, Time or Ease of use Which product feature interests a customer? Will help develop Competitive Strategy. Else customers will not perceive any real difference between competitive alternatives and choose basis price. Positioning Strategy is to create and maintain distinctive differences that will be noticed and valued by Potential Target Customers for a long

SERVICE POSITIONING …. Service firms to provide a narrow product mix for a particular market segment – a group of buyers with common characteristics, needs, purchasing behavior or consumption pattern. Concentrate resources on strategically important elements of service operations. A firm’s focus can be described in two dimensions - Market focus and Service focus. Market focus is extent to which a firm serves few or many markets. Service focus is extent to which a firm offers few or many services. These two dimensions describe four Basic focus Strategies. A fully focused firm provides limited range of services (maybe one core product) to a narrow and specific

SERVICE POSITIONING    

  MANY NUMBER OF MARKETS SERVED

FEW

…..

BREADTH OF SERVICE OFFERING NARROW WIDE UNFOCUSED SERVICE (EVERYTHING FOCUSED FOR EVERYONE) FULLY FOCUSED( MARKET SERVICE & FOCUSED MARKET FOCUSED)

Service focused firms offer narrow range of services to a fairly broad market. Many Service providers fall into unfocused category because they try to serve broad markets and provide a wide range of

SERVICE POSITIONING …. SELECTION OF FOCUS Fully focused strategy has Risks and Opportunities. Developing recognized expertise in a well defined niche may protect against potential competition and charge premium price. Risk-Market small for volume business and financial viability is ? The demand may be displaced by generic competition or customers may be affected by economic downturn. Firms with narrow product line may serve multiple segments (service focused) to create portfolio

SELECTION OF FOCUS …… Offering broad product lines to narrow target segment has potential of selling multiple services to customers. Firms must have operational capability. To cross-sell additional services to btob, client companies may have different purchase groups.

MARKET SEGMENTATION

Firms offer services to segmented markets to identify segments it can serve best. Needbased segments have customers valuing specific attributes. Mass customization to serve specific market segment by offering Standardized Core product with tailor-made supplementary service elements. Creation of customer Database and Analytical

CUSTOMER EXPECTATONS OF SERVICES

HOW CUSTOMERS EXPECTATIONS FORMED  Good service expectations varies from business: expectations from a vet to treat a pet or accountant for tax returns. Vary in differentiated positioned service providers – low cost airlines vs. full service. Purchase dept. evaluate against internal standards. Expectations change over time – Customers seek participative role in health care decisions. CUSTOMER EXPECTATIONS COMPONENT  Desired Service: Can and Should receive  Zone of tolerance: Constant delivery difficult. Extent of variation customers willing to accept.  Adequate Service: Minimum Service levels  Predicted Service: Anticipate Levels of Service between Desired and Adequate

CUSTOMER EXPECTATONS …… Situational factors: Service Expectations affected By temporary reasons for purchase – Consumer’s mood, the Weather, Time Constraints and Urgency Reasons for purchase: Use of a Hotel Services – Breaking journey, Spending week-end, Using for Corporate Training, Shift of residence, Holding Social programmes. Consumer’s mood: Good mood means higher ZOT and level of adequate service lower. Reverse

MEASURING SERVICE QUALITY Consumers evaluate 5 dimensions of service quality: Tangibles – physical facilities, (Soap, Heating, Room safe malfunctioned and light flashed and beeped at 3 AM) Reliability – perform service promised dependably and accurately (Service not in line with Broch.), Responsiveness – firm’s staff help customers with prompt service (Hotel staff ignored the presence, Room service reminded to remove tray) Assurance – Inspire trust and confidence through knowledge competence and courtesy and

THE GAP MODEL

A MODEL OF SERVICE QUALIY Service Quality means consistently meeting or exceeding Customer Expectations. The Manager’s task is to balance Customer Expectations with Perceptions of service delivery and to close any gaps between the two. P- E will give Service Quality. A Model Of Service Quality is given by Gap Model. The figure Identifies 5 Potential Gaps. The Horizontal dash line divides Service Quality Gaps that are SP related and Consumer

THE GAP MODEL

THE GAP MODEL

The Knowledge Gap 1 :Difference between Customers’ Needs & Expectation and SP’s Perceived Customer Expectation. A contractor wants to use the best grade electrical wire. Sub-contractor perceives contractor wants to keep costs down and uses low grade wire. The converse happening is also true. Extra services provided raise Expectations and also add to the cost. Cause Of Gap

Strategies to

THE GAP MODEL The Standards Gap 2: Difference between firm’s perceived Customer Expectation and its translation to Service Quality Specifications. Reasons: 1.Resource Constraint ( Seasonal Service demand), 2. Market Conditions, 3. Indifference to Customers’ Needs Cause Of Gap Reduce Gap Resource Constraint Commitment Market Conditions Quality Indifference Expectation

Strategies to Firm’s

Develop Service Goals Standardize tasks & Address feasibility of Customer

THE GAP MODEL The Delivery Gap 3: Difference between firm’s Service Quality Specifications and Delivery of Specifications. This could be due: Service Provider’s employees’ Performance Cause Of Gap Reduce Gap Employee unaware Teamwork of Specifications. Skills to Perform technology Specifications Unwilling to Perform

Strategies to Enhance Employee, job-fit Supervisory Control,

THE GAP MODEL Communication Gap 4 :The difference between the External communication about service (Advertising, Sales Promise) and Service delivered. To increase patronage, firms are tempted to make promises which may be difficult or impossible to deliver. Cause Of Gap Reduce Gap

Strategies to

Poor Communication Improve lateral Communication Over Promising Avoid propensity to over promise

THE GAP MODEL The Perception Gap 5: The difference between what Consumers Receive and what they Expected. This is the sum of Gaps 1 to 4, both in direction and magnitude. Suppose a Consumer Survey gives scores to Gaps 1 to 4 on a scale of -3 to +3 as: +1, -3, +1 and 0, The score for Gap 5 would be +1 +(3)+1+0 =-1 This indicates the Service Performance fell Short of Customer Expectations. The SP

BUILDING CUSTOMER RELATIONSHIP

Relationship Marketing represents a Paradigm shift in Marketing – away from Acquisitions toward a retention/ relationship focus. A Strategic orientation – focus on keeping and improving current customers rather than acquiring new customers. The customers prefer an ongoing relationship, not switch continually in search for value. Targeting, acquiring and retaining the right customers is at the CORE of successful firms. The fact is it is usually much cheaper to keep a current customer than to attract new one. Firms frequently focus on attracting customers but do not pay attention to keeping them.

BUILDING CUSTOMER

….

Customer Loyalty is described as: Willingness to using Products/ Services on a long term, Repeated purchase preferably on exclusive basis, Recommend firm’s Products/ Services to friends and associates. Customers changing Brands give adequate signals by reducing purchase and shifting to another Service provider. Researches have found that the longer customers stayed with a firm, the more profitable they became. Four factors which create incremental profits are: 1. Profit derived from increased purchases. 2. Profits from Reduced Operating Costs. 3. Profits from referrals to other

BUILDING CUSTOMER

….

Impact on profits also depend upon Product Life cycle of Services – more impact of referrals in early stages of PLC. Customer Lifetime Value – Customers potential to generate ongoing Stream of profits and are firm’s important financial asset. Marketing Services programs should be seen as investments rather than just operating expenses. The discounted value of each customer over expected lifetime with the firm gives CLV.

BUILDING CUSTOMER

….

Analyzing & Managing Customer Base: Firms should adopt a Strategic approach to retaining, upgrading and even terminating service to unprofitable customers. Firms need not make efforts to treat all customers with the same level of intensity. Most firms have several layers of customers basis profitability and these layers have different needs and service expectations. Customer layers form 4 layers of a pyramid

BUILDING CUSTOMER

….

Platinum: A small %age, Heavy user, Contribute large profit, Less Price sensitive and expect large level of service Gold: Larger customer base heavy users with individuals contribute less to profits. Slightly sensitive to price, less committed to firm. Iron: Provide bulk of customer base. Firm builds and maintains certain capacity level of Infrastructure needed for servicing Gold and Platinum customers. Gives the firm the economies of scale. Iron customers are marginally

SERVICE RECOVERY Service Recovery refers to the action taken by an organization response to a service failure. Failure occurs for many reasons: The service may be unavailable when promised Delivered late slow The outcome may be incorrect or poorly executed Employees may be rude or uncaring These failures bring about negative feelings and responses for the customers. Result in customers Leaving and sharing negative experiences. May even challenge the organization through customers rights organizations or legal channels

SERVICE RECOVERY Repeated Service Failures without an effective Recovery Strategy in place can aggravate even the best employees. The costs in Employee Morale and even lost employee can be huge

THE RECOVERY PARADOX

It is suggested that dissatisfied customers who experience a high level of excellent service recovery, may ultimately be even more satisfied and more likely to repurchase than are those who were satisfied I the first place.

SERVICE RECOVERY Recovery Paradox is more complex than it may seem on the surface. It is expensive to fix mistakes. Empirical Research suggests that only under the very highest levels of customers’ Service Recovery ratings will we observe increased satisfaction and loyalty. It is safe to say that “ Doing it right the first time “ is still the best and safest strategy. However, when a failure does occur, then every effort at a superior Recovery should be made to mitigate its negative effects. In cases where the failure can

CUSTOMER COMPLAINTS & ACTIONS If customers initiate actions following service failure, the action can be of various types as shown in the Fig. From company’s point of view any customer who complains on the spot is the best case scenario. Company has the chance to respond immediately. If they don’t complain immediately, customers may choose to complain later to the provider by phone or in writing, or even write or call the corporate offices of the company. In all the above cases, the

CUSTOMER COMPLAINTS & ACTIONS (1) Passive: This group of customers is least likely to take any Action. Less likely to spread negative Word of Mouth. They often doubt the effectiveness of complaining, thinking the consequences will not merit the time and effort spent. (2) Vocal:

These customers actively complain to the service Provider, Less likely to spread negative word of mouth, switch patronage, or go to a third party with

CUSTOMER COMPLAINTS & ACTIONS Irate: These customers more likely to engage in negative word of mouth to friends and relatives and switch providers. They are angry with the service provider although they do believe that complaining to the service provider can have social benefits. They are less likely to give the service provider a second chance. Activists: These consumers have high propensity to complain. They will complain to the provider, they will tell

CUSTOMER COMPLAINTS & ACTIONS WHEN CUSTOMERS COMPLAIN, WHAT DO THEY EXPECT? Customers want justice and fairness in the handling of their complaints. Customers are looking for: OUTCAME FAIRNESS PROCEDURAL FAIRNESS INTERACTIONAL FAIRNESS Outcome Fairness: They expect equity in the exchange- i.e. they want to feel that the company has “Paid” for its mistakes in a manner at least equal to what the customer has suffered. The company’s

CUSTOMER COMPLAINTS & ACTIONS

On the other hand, customers can be comfortable if they are overly compensated. E.g. Domino’s Pizza offered not to charge if the delivery was after 30 minutes of ordering. Many customers were not comfortable asking for this level of compensation, especially if the driver was only few minutes late. Procedural Fairness: In addition to fair compensation, customers expect fairness in policies, rule and timeliness of complaint redress. They want easy access to the complaint process. Fair procedures are

CUSTOMER COMPLAINTS & ACTIONS Interactive Fairness: Customers expect to be treated politely, with care and honesty. This form of fairness can dominate the others if customers feel the company and its employees have uncaring attitude and have done little to try to resolve the problem. Often rude and uncaring behavior of employees is due to lack of training and empowerment- a frustrated, frontline employee who has no authority to compensate the customer may easily respond in an aloof

Service Marketing System: (1) High Contact Service-e.g., Hotel Service Marketing System Service Delivery SystemOther Contact Points Service Operations SystemOther

Customers Interior & Exterior Facilities

Technical Core

The Customer

Equipment

Service People

Backstage Front Stage Other (invisible) (visible) Customers

Advertising Sales Calls Market Research Surveys Billing / Statements Miscellaneous Mail, Phone Calls, Faxes, etc. Random Exposure to Facilities / Vehicles Chance Encounters with Service Personnel Word of Mouth

Service Marketing System: (2) Low Contact Service-e.g., Credit Card Service Marketing System Service Delivery System Service Operations System

Advertising

Mail Technical Core

Backstage (invisible)

Other Contact Points

The

Self Service Equipment Customer Phone, WebFax, site etc. Front Stage (visible)

Market Research Surveys Random Exposures Facilities, Personnel

Word of Mouth

SERVICE BLUEPRINTING A service blueprint is a picture or map that accurately portrays the service system so that the different people involved in providing it can understand and deal with it objectively regardless of their roles or their

SERVICE MAPPING/BLUEPRINTING A tool for simultaneously depicting the service process, the points of customer contact, and the evidence of service from the customer’s point of view. Process

Service Mappin g

Points of Contact Evidence

SERVICE BLUEPRINT COMPONENTS CUSTOMER ACTIONS line of interaction

“ONSTAGE” CONTACT EMPLOYEE ACTIONS line of visibility

“BACKSTAGE” CONTACT EMPLOYEE ACTIONS

line of internal interaction SUPPORT PROCESSES

SERVICE BLUEPRINT COMPONENTS

SERVICE BLUEPRINTING: KEY COMPONENTS 1. Define standards for front stage activities

2. Specify physical evidence 3. Identify principal customer actions 4. ------------line of interaction (customers and front stage personnel)-------5. Front stage actions by customer-contact personnel 6. ------------line of visibility (between front stage and backstage)-------------7. Backstage actions by customer contact personnel 8. Support processes involving other service personnel 9. Support processes involving IT

Where appropriate, show fail points and risk of excessive waits

Simplified Example: Blueprinting a Hotel Visit (extract only) Hotel exterior, lobby, employees, key

Stage

Physical Evidence

Front

Line of Interaction

Make Customer reservation Actions Employee Actions Face-to-face Phone Contact

Backstage

Line of Visibility

Arrive, valet park

Check-in at reception

Doorman greets, valet takes car

Receptionist verifies, gives key to room

Elevator, corridor, room, bellhop Go to room

Rep. records, confirms Make up Room

Valet Parks Car Enter data

Register guest data

SUPPORT PROCESS

CONTACT PERSON (On Stage) (Back Stage)

CUSTOMER PHYSICAL EVIDENCE

EXPRESS MAIL DELIVERY SERVICE Truck Packaging Forms Hand-held Computer Uniform

Truck Packaging Forms Hand-held Computer Uniform

Custo mer Calls

Customer Gives Package

Receive Package

Driver Picks Up Pkg.

DELIV ER PACK AGE

Customer Service Order

Dispatch Driver

Airport Receives & Loads

Fly to Sort Center

Fly to Destination Load on Airplane

Sort Packages

Unload & Sort

Load On Truck

CONTACT PERSON SUPPORT PROCESS(Back Stage) (On Stage) CUSTOMER

PHYSICAL EVIDENCE

OVERNIGHT HOTEL STAY Hotel Exterior Parking

Arrive at Hotel

Cart for Desk Elevators Cart for Bags Registration Hallways Bags Papers Room Lobby Key Give Bags Check in to Bellperson

Go to Room

Greet and Process Take Registration Bags

Receive Bags

Room Amenities Bath

Sleep Shower

Menu

Call Room Service

Deliver Bags

Take Bags to Room

Registration System

Delivery Food Tray Food Appearance Receive Food

Deliver Food

Eat

Bill Desk Lobby Hotel Exterior Parking Check out and Leave

Process Check Out

Take Food Order

Prepare Food

Registration System

BUILDING A SERVICE BLUEPRINT

Step 1

Step 2

Step 3

Step 4

Step 5

Step 6

Identify the process to be blueprinted.

Identify the customer or customer segment.

Map the process from the customer’s point of view.

Map contact employee actions, onstage and back-stage.

Link customer and contact person activities to needed support functions.

Add evidence of service at each customer action step.

SERVICE BLUEPRINTING STEPS • Identify Process • Isolate fail points 3. Establish a time frame 4. Analyze profitability 

APPLICATION OF SERVICE BLUEPRINTS New Service Development • concept development • market testing

Supporting a “Zero Defects” Culture • managing reliability • identifying empowerment issues

Service Recovery Strategies • identifying service problems • conducting root cause analysis • modifying processes

BLUEPRINTS CAN BE USED BY: Service Marketers – creating realistic customer expectations • service system design • promotion

Operations Management – rendering the service as promised • managing fail points

Human Resources – empowering the human element • job descriptions • selection criteria • appraisal systems

System Technology – providing necessary tools: • system specifications • personal

Degree of Interaction & Customization of Services CUSTOMIZATION

Standardized

Customized

Service Factory Service Shops

Capital Intensive DEGREE OF LABOR INTENSITY

Labor Intensive

Source: Robert Johnston

Airlines Trucking Hotels Resorts & Recreations

Mass service

Retailing/Warehousing

Schools Retail aspects of Commercial Banking

Hospitals Auto repair Other repair services

Professional Services Doctors Lawyers Accountants Architects

Factors Necessary for Appropriate Service Standards Standardization can take 3 forms:

• Substitution of technology for personal contact & human effort 3 Improvement in work methods 4 Combination of these two methods Standardizing whether accomplished by technology or by improvements in work processes, Reduces GAP 2 Both technology & improved work processes structure important elements of service provision and also facilitate goal setting

CUSTOMER – DEFINED SERVICE STANDARDS Once marketers understand what customers expect Critical Challenge is using this knowledge to set service quality standards and goals for the Organization. Difficulty in Setting Standards to match or exceed customer Expectations is because it requires that the Marketing & Operations within a company work together. ( Also known as Functional Integration)

Factors Necessary for Appropriate Service Standards

The Translation of Customer ExpectationsService Quality Standards: – Degree to which tasks and behaviors performed can be Standardized or made Routine Some managers feel that services cannot be standardized As standardizing the tasks is perceived as being impersonal, inadequate and not in customers best interest. It is also inconsistent with employee empowerment- they feel controlled Services are too intangible to be standardized (This leads to vague & loose standard setting with little or no measurement or feedback.) In reality many service tasks are routine – specific rules and standards can be fairly established and effectively executed.

Factors Necessary for Appropriate Service Standards Employees welcome knowledge to perform actions most efficiently : It frees them to use their ingenuity in the more personal & individual aspects of their jobs. Even in Highly Customized Services – Many aspects of Service can be made Routine Dentist & Physician–Examining Patients weighing, taking routine measurements, billing. More time of the Dentist & Physician can be spent on the expert services of diagnosis or patient care

Customer – Not Company – Defined Standards Company Defined – Established to reach internal company goals for productivity, efficiency, cost, or technical quality. To close GAP 2 standards must be based on Customer Requirements and Expectations rather than just on internal company goals Instead company should set CustomerDefined Standards- Operational standards based on pivotal customer requirements that are visible to & measured by customers

Customer-Defined Service Standards • • • • • •

Hard Customer-Defined Standards Soft Customer-Defined Standards One-Time Fixes Building Blocks: The Service Encounter Sequence Expressing Customer Requirements as Specific Behaviors and Action Measurements of Behavior and Actions

Process For Developing Customer-Defined Standards 1. Identify Existing or Desired Service Encounter

2. Translate Customer expectations into Behaviors / Actions 3. Select Behaviors/Actions for Standards Measured by audits or operating data

4. Set Hard or Soft Standards Hard

5. Develop Feedback Mechanisms

Soft

6. Establish measures against standards 7. Track Measures Against Standards 8. Provide Feedback about Performance to Employees 9. Periodically Update Target Levels and Measures

Measured by transaction based surveys

APPROACHES TO SERVICE RESEARCH Service-Quality Information System: Too much Research information obscures most meaningful insights, may intimidate intended users. Also, incomplete information injects needless guessing into decision making. Nature of Services, firm’s Service Strategy and needs of information users determine

Market Research Type of Research

Primary Research Objectives

Complain t solicitatio n Critical incident studies

To identify/attend to dissatisfied customers To identify common service failure points To identify “best practices” at transaction level To identify customers requirements as input for qualitative studies To identify common service failure points To identify systemic strengths and weaknesses in

Qualitative /Quantitati ve

Monetar y

Time

Frequency

Qualit ative

Low

Low

Contin uous

Qualit ative

Low

M oder ate

Periodi c

Market Research contd ….. Type of Research Requirement s research

Primary Research Objectives

To identify customer requirements as input for qualitative research Relationshi To monitor and track p surveys service performance and To assess overall SERVQUAL company surveys performance compared with that of competition To determine the links between satisfaction and behavioral intentions To assess gaps between customer expectations and

Qualitativ e/Quantit ative

Monet ary

Time

Frequenc y

Qualita M tive oder ate

M oder ate

Annua l

Quanti tative

Low

Contin uous

Low

Market Research contd ….. Monetar y

Time

Frequency

To obtain immediate Quanti Low feedback on performance tative of service transactions To measure effectiveness of changes in service delivery To assess service performance of individuals and teams To use as input for process improvements To identify common service failure points To create dialogue with Qualit Moder Service ative ate expectatio important customers To identify what individual n meetings large customers expect and then to assure that it and is delivered

Low

Continuous

Type of Research

Trailer calls

reviews

Primary Research Objectives

Qualitati ve/Quant itative

M Annual oder ate

Market Research contd ….. Type of Research

Primary Research Objectives

Process To determine checkpoint customer perceptions evaluation of long term s

Market – oriented ethnograp hy

Qualit ative/ Quanti tative

Monet ary

Qualit Mode ative rate

professional services during service provision To identify service problems and solve them early in the To research customers Qualit Mode service relationship in natural settings ative rate To study customers from cultures other than your home country

Time

Frequen cy

M Periodi oder c ate

High Periodi c

Market Research contd ….. Type of Research

Primary Research Objectives

Qualitati ve/Quant itative

Mystery shopping

To measure individual employee performance for evaluation , recognition and rewards To identify systemic strengths and weaknesses in customer-contact To monitor changing services customer expectations

Customer panels

Lost customer research

To provide a forum for customers to suggest and evaluate new service ideas To identify reasons for customer defection

Monetar y

Time

Frequency

Quant Low itative

Low

Quarterly

Qualit Mode ative rate

M Continuo oder us ate

Qualit Low ative

Low

Continuo us

Market Research contd ….. Type of Research

Primary Research Objectives

Qualita Mone tive/Qu tary antitat ive

T ime

Frequenc y

Future expectat ions research

To forecast future expectations of customers To develop and test new service ideas

Qualita High tive

H igh

Periodic

Databas e marketin g research

To identify the individual requirements of customers using information technology and database

Quantit High ative

H igh

Continuo us

Provider Gap 3

CUSTOMER

COMPANY

Service Delivery Service Performance Gap

Customer-Driven Service Designs and Standards

Understanding the Components of the Augmented Service Product

Shostack’s Molecular Model of a Total Market Entity - Passenger Airline Service Distribution Price

Vehicle

Service frequency

Transport Pre- and post-flight service

In-flight service

Food and drink

KEY

Tangible elements Intangible elements

Marketing Positioning (Weighted toward evidence)

Source: Shostack

Core Products and Supplementary Services Most firms offer customers a package of benefits: – core product (a good or a service) – supplementary services that add value to the core In mature industries, core products often become commodities Supplementary services help to differentiate core products and create competitive advantage by: – facilitating use of the core service – enhancing the value and appeal of the core

Core &Supplementary Elements

Define core product and determine supplementary elements to augment this core Product. Core+Supplementary=Augmented Product Determine the benefits which create the most value for customers. Differentiated the Service Package from the competition in ways that are meaningful to target customers. Determine current levels of service on the core product and of the supplementary elements? Determine the charges for higher service levels on key attributes (e.g., faster response, better physical amenities, easier access, more staff, superior caliber, personnel)? Or if the service levels can be cut and charge less?

Core and Supplementary Services in a Luxury Hotel (Offering Guests Much More than a Cheap Motel!)

R e s e r v a tio n C a s h ie r

V a le t P a r k in g

B u s in e s s C e n te r

Ro o m S e r v ic e

R e c e p tio n A B e d fo r th e N ig h t in a n E le g a n t P r iv a te R o o m w ith a B a th r o o m

W a ke-up C a ll Te le p h o n e

Baggage S e r v ic e

C o c k ta il Bar E n te r ta in m e n t/ S p o r ts / E x e r c is e

R e s ta u r a n t

Documenting Delivery Sequence over Time The Time Dimension in the Augmented Service Product Reservation Parking

Get car Check in USE ROOM

Check out Phone USE GUESTROOM OVERNIGHT

Porter Meal

Pre Visit

Pay TV

Room service

Time Frame of an Overnight Hotel Stay (real-time service use)

Employees’ Role in Service Delivery Service Culture The Critical Importance of Service Employees Boundary-Spanning Roles Strategies for Delivering Service Quality Through People Customer-Oriented Service Delivery

Service Leadership & Culture Strong Service Culture developed and continuously Reinforced by Management Management Leadership required to change Values, Goals and Aspirations of Front Line staff to be in line with Service Organisation Organisation culture have core values as Excellence, Innovation, Team work, Respect, Integrity and Social Profit Shared Perception of What is important in an organization Shared Values and Beliefs about Why these things are important

Service Leadership & Culture

Strong Service Culture focus on Front Line Being Lifeline of Services business. Revenues driven by what happens at Service Encounter. The Service Triangle Customer Service Encounter Front Line

Top Management, Employees Support Front Line

Highlights importance of front line showing the role of Top Management and employees is to support Front Line to deliver excellence

Service Culture

Corporate culture is defined as The pattern of shared values and beliefs that give the members of an organization meaning, and provide them with the rules for behavior in the organization. 111

Benefits:

Empowerment

– quicker responses to customer needs – quicker responses to dissatisfied customers – employees feel better about their jobs and themselves – employees tend to interact with warmth/enthusiasm – empowered employees are a great source of ideas – great word-of-mouth advertising from customers

Drawbacks: – potentially greater dollar investment in selection and training – higher labor costs – potentially slower or inconsistent service delivery – may violate customers’ perceptions of fair play – employees may “give away the store” or make bad decisions

Traditional Organizational Chart Manager

Superviso r

Frontline Employ ee

Frontline Employ ee

Frontline Employ ee

Superviso r

Frontline Employ ee

Frontline Employ ee

Frontline Employ ee

Frontline Employ ee

Frontline Employ ee

Customers 113

Customer-Focused Organizational Chart

Customers Frontline Employ ee

Frontline Employ ee

Frontline Employ ee

Frontline Employ ee

Frontline Employ ee

Superviso r

Frontline Employ ee

Frontline Employ ee

•Frontline Employee

Superviso r

Manager 114

EMPLOYEES’ ROLE IN SERVICE DELIVERY

The Critical Importance of Service Employees It is very important to focus on employees because : They are the service They are the organization in the customer’s eyes They are the brands They are the marketers In many cases , the contact employee is the service – there is nothing else. E.g. in most personal and professional services (like haircutting, physical trainers, child care , cleaning /maintenance etc.) the contact employees provide s the entire service single handedly. The offering is the employee. Thus

EMPLOYEES’ ROLE IN SERVICE DELIVERY

Because contact employees represent the organization and can directly influence customer satisfaction, they perform the role of marketers. They physically embody the product and are the walking billboards from the promotional point of view. Whether acknowledged or not, actively selling or not, service employees perform marketing functions. They can perform these functions well, to the organization’s advantage, or poorly to the organization’s detriment. EMPLOYEE SATISFACTION, CUSTOMER SATISFACTION AND PROFITS

The Services Marketing Triangle Company (Management)

Internal Marketing “Enabling the promise”

Employees

External Marketing “Making the promise”

Interactive Marketing “Delivering the promise”

Customers 117

Source: Adapted from Mary Jo Bitner, Christian Gronroos, and

Services Marketing Triangle Applications Exercise Focus on a service organization. In the context you are focusing on, who occupies each of the three points of the triangle? How is each type of marketing being carried out currently? Are the three sides of the triangle well aligned? Are there specific challenges or barriers in any of the three areas? 118

Ways to Use the Services Marketing Triangle Specific Service Overall Strategic Implementation Assessment – How is the service organization doing on all three sides of the triangle? – Where are the weaknesses? – What are the strengths?

– What is being promoted and by whom? – How will it be delivered and by whom?

– Are the supporting systems in place to deliver the promised service? 119

EMPLOYEE SATISFACTION, CUSTOMER SATISFACTION AND PROFITS Research has shown that both a climate for service and a climate for employee wellbeing are highly correlated with overall customer perceptions of service quality.

Service Quality Dimensions Reliability Responsiveness Assurance Empathy Tangibles

121

Service Employees Who are they? – “boundary spanners”

What are these jobs like? – emotional labor – many sources of potential conflict •person/role •organization/client •interclient

– quality/productivity tradeoffs

Boundary Spanners Interact with Both Internal and External Constituents External Environment

Internal Environment

123

Boundary-Spanning Workers Juggle Many Issues Person versus role Organization versus client Client versus client

124

Person/Role Conflict

This conflict arises when what they are asked to do things that are quite different from their personalities.

125

Organization/Client Conflict Front line executives have two bosses: The organization & the individual customer The conflict may arise when the employee has To make a difficult choice between the customer, the rules & satisfaction for the customer 126

Interclient Conflict Employee

Serving customers in turn

Serving many customers simultaneously

127

Quality/Productivity Trade-Offs Front-line service employees have to both : Effective & Efficient They are expected to deliver satisfying service to customers and at the same time have to be 128 cost effective & productive .

Pricing Of Services

Three Key Ways Service Prices Are Different For Consumers Customer knowledge of Service Prices The Role of Non-monetary Costs Price as an Indicator of Service Quality

Customer Knowledge of Service Prices Service heterogeneity limits knowledge Providers are unwilling to estimate prices Individual customer needs vary Price information is overwhelming in services Prices are not visible

The Role of Nonmonetary Costs Time Costs Search Costs Convenience Costs Psychological Costs

Price as an Indicator of Service Quality Customers depend on price as a cue to quality and because price sets expectations of quality, service prices must be determined carefully.

Approaches to Pricing Services Cost-based

t pe

m

Co it

b nd

b nio d

e as

D

a em

d e as

Cost-Based Pricing •Costs are difficult to trace. •Labor is more difficult to price than materials. •Cost may not equal value.

Competition-Based Pricing •Small firms may charge too little to be viable. •Heterogeneity of services limits comparability. •Prices may not reflect customer value.

Demand-Based Pricing •Monetary price must be adjusted to reflect the value of nonmonetary costs. •Information on service costs is less available to customers, hence price may not be a central factor.

Four Customer Definitions of Value Value is low price.

Value is the quality I get for the price I pay.

Value is everything I want in a service.

Value is all that I get for all that I give.

What Makes Service Pricing Strategy Different (and Difficult)? No ownership of services --hard for firms to calculate financial costs of creating an intangible performance Variability of inputs and outputs --how can firms define a “unit of service” and establish basis for pricing? Many services hard for customers to evaluate --what are they getting in return for their money? Importance of time factor --same service may have more value to customers when delivered faster Delivery through physical or electronic channels --may create differences in perceived value

Objectives of Pricing Strategies Revenue and profit objectives – Seek profit – Cover costs Patronage and user baserelated objectives – Build demand – Build a user base

The Pricing Tripod Pricing Strategy

Costs

Competition Value to customer

Three Main Approaches to Pricing Cost-Based Pricing – Set prices relative to financial costs (problem: defining costs) Competition-Based Pricing – Monitor competitors’ pricing strategy (especially if service lacks differentiation) – Who is the price leader? (one firm sets the pace) Value-Based – Relate price to value perceived by customer

Activity-Based Costing: Relating Activities to the Resources They Consume Managers need to see costs as an integral part of a firm’s effort to create value for customers When looking at prices, customers care about value to themselves, not what production costs the firm Traditional cost accounting emphasizes expense categories, with arbitrary allocation of overheads ABC management systems examine activities needed to create and deliver service (do they add value?) Must link resource expenses to: – variety of products produced

Net Value = (Benefits – Outlays)

EffortTime

Perceive d Benefits

e

Perceived Outlays

Enhancing Gross Value

Pricing Strategies to Reduce Uncertainty – service guarantees – benefit-driven (pricing that aspect of service that creates value) – flat rate (quoting a fixed price in advance) Relationship Pricing – non-price incentives – discounts for volume purchases – discounts for purchasing multiple services Low-cost Leadership – Convince customers not to equate price with quality – Must keep economic costs low to

Paying for Service: The Customer’s Perspective Customer “expenditures” on service comprise both financial and non-financial outlays Financial costs: – price of purchasing service – expenses associated with search, purchase activity, usage Time expenditures Physical effort (e.g., fatigue, discomfort) Psychological burdens (mental effort, negative feelings) Negative sensory burdens (unpleasant sensations affecting any of the five

Determining the Total Costs of a Service to the Consumer Search Costs

Price Related Monetary Costs Time Costs

Purchase and Use Costs

Physical Costs Psychological Costs Sensory Costs

After Costs

Necessary follow-up Problem solving

Operating Costs Incidental Expenses

Trading off Monetary and Non- Monetary Costs Which clinic would you patronize if you needed a chest x-ray (assuming all three clinics offer good quality) ? Clinic A

Clinic B

Clinic C

 Price $45  Located 1 hour away by car or transit  Next available appointment is in 3 weeks  Hours: Monday – Friday, 9am – 5pm  Estimated wait at clinic is about 2 hours

 Price $85  Located 15 min away by car or transit  Next available appointment is in 1 week  Hours: Monday – Friday, 8am – 10pm  Estimated wait at clinic is about 30 - 45 minutes

 Price $125  Located next to your office or college  Next appointment is in 1 day  Hours: Mo –Sat, 8am – 10pm  By appointment - estimated wait at clinic is about 0 to 15 minutes

Increasing Net Value by Reducing Non-financial Costs of Service Reduce time costs of service at each stage Minimize unwanted psychological costs of service Eliminate unwanted physical costs of service Decrease unpleasant sensory costs of service

Revenue Management: Maximizing Revenue from Available Capacity at a Given Time Based on price customization - charging different customers (value segments) different prices for same product Useful in dynamic markets where demand can be divided into different price buckets according to price sensitivity Requires rate fences to prevent customers in one value segment from purchasing more cheaply than willing to pay RM uses mathematical models to examine historical data and real time information to determine – what prices to charge within each price bucket

The Strategic Levers of Revenue (Yield) Management Price Duration

Fixed Predictabl e

Variable

Quadrant 1:

Quadrant 2:

Movies Stadiums/Arenas Function Space

Hotel Rooms Airline Seats Rental Cars Cruise Lines

Quadrant 3:

Quadrant 4:

Unpredictab Restaurants le Golf Courses

Continuing Care Hospitals