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Center for Human Services

About Center for Human Services

Center for Human Services (CHS) is a community-based not-for-profit youth and family services agency that has been a resource for children, adults, and families since 1970. The mission of the Center for Human Services is to strengthen the community through counseling, education, and support for children, youth, adults, and families in North King and South Snohomish Counties.

Project Information

Changes Implemented

In order to increase participation, we made the following changes:
  1. We surveyed our clients to find out what might increase participation.
  2. We started awarding gift cards to clients that attended 100 percent of their group and individual sessions during a two-week cycle.


As a result of these changes, the attendance rate increased from 75.5 percent at baseline to 89.6 percent after the second PDSA Cycle.

Figure 1

The overall attendance rate dropped during the first PDSA Cycle, so we modified our approach
and continued to test this change.

Business Case

Increasing participation for group and individual treatment sessions also increases revenue. The cost of each missed group session costs $40 per person. Increasing attendance by 15 percentage points yields 72 additional sessions for an annual increase in revenue of $5,184.

Lessons Learned

In the course of this Change Project, we learned that:
  • Engagement in early recovery is crucial to success.
  • Recognition of client effort is important.
  • Increased participation yields better group cohesion.
One client took a $50 cab ride to his appointment so that he would remain eligible for the gift card and receive recognition for his attendance.

Next Steps

We plan to continue to use PDSA Cycles to refine this incentive program while monitoring the attendance rate and building the business case for process improvement. We are also making plans for spreading this change to other programs.

Last updated 05/27/2010

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