Three sites providing services to adults and adolescents: Oxnard Simi Valley Ventura Total population served approximates 500 clients on any given month.

Executive Sponsor-Patrick Zarate, Division Manager Change Leader- Kathy Mulford, CA III Change Team- David Hagerty, ADTS II Patty Dudley, OA III

Objective: Decrease the number of client no shows to adolescent groups from 41% to 35% Plan: 1 st - Contact clients the day after missing a group to invite them to the next group. 2 nd - Re-assign clients to groups maximizing the therapeutic benefit 3 rd - Call all clients the day of their group as a reminder

Aug - Oct 2008: 41% no shows Baseline data 1 st Change: Jan 2009: 43% no show rate Feb 2009: 41% no show rate No notable change 2 nd Change: Mar 2009: 31% no show rate Decrease is no shows from 41% to 31%

3 rd Change: Apr 2009 – 22%Dec 2009 – 31% May 2009 – 21%Jan 2010 – 22% Jun 2009 – 23%Feb 2010 – 17% Jul 2009 – 27%Mar 2010 – 15% Aug 2009 – 30%Apr 2010 – 28% Sep 2009 – 19%May 2010 – 35% Oct 2009 – 27%Jun 2010 – 21% Nov 2009 – 24%Jul 2010 – 22% Significant decrease in no shows was realized. No shows have been at or below goal of 35% for over 1 year.

Calling the clients after they missed a group had no notable effect on the no show rate after 2 months. Re-assigning the clients to groups based on maximizing the therapeutic benefit did decrease the no show rate over the following month. When all clients were called the day of their group, a significant drop occurred in the no show rate, which has been maintained over a 16 month period. Though there have been ups and downs the original goal of 35% has never been exceeded. Over the past 16 months the average no show rate has been 24%.

Executive Sponsor-Patrick Zarate, Division Manager Change Leader- Colleen Kelly, CAIII Change Team- Linda Johnson, ADTS II Samantha McNeely, OA III

Objective: Decrease the number of client no shows to adolescent groups by 15%. Plan: 1 st – To call clients who were a N.S. for group to say they were missed and remind them of next group 2 nd – Use a portion of group time to discuss the importance of regular attendance and inquire why they are not attending 3 rd - Call all clients the day of their group as a reminder

November 2008: 31% no shows Baseline data 1 st Change: Dec 2008: 19% no show rate Jan 2009: 25% no show rate Average no show rate of 22% 2 nd Change: Feb 2009: 19% no show rate Decrease is no shows noted from the previous month

3 rd Change: Apr 2009 – 33%Dec 2009 – 13% May 2009 – 22%Jan 2010 – 20% Jun 2009 – 38%Feb 2010 – 18% Jul 2009 – 28%Mar 2010 – 9% Aug 2009 – 20%Apr 2010 – 17% Sep 2009 – 10%May 2010 – 22% Oct 2009 – 10%Jun 2010 – 17% Nov 2009 – 12%Jul 2010 – 30% Significant decrease in no shows was realized. No shows have been at or below goal of 26% on average for over 1 year.

Placing phone calls after groups and before groups made a significant difference in attendance. The months where there was an increase the team discussed and agreed that it was due to holidays and school breaks. Jan 2009 – 25% Holidays Apr 2009 – 33% Spring Break Jun 2009 – 38% Counselor Vacation Jul 2010 – 30% Counselor Vacation Over the past 16 months the average no show rate has been 20%