Process improvement for behavioral health

Avoid Friday Admissions


Clients leave treatment if they start just before the weekend, when residential treatment provides too little structure and support.


Avoid admitting clients to residential treatment on Friday.

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Fayette Companies in Peoria, Illinois helped reduce the percentage of discharges that left against medical advice within the first 7 days from 21 percent to 5 percent by eliminating Friday admissions to the residential program. They realized that 47 percent of their patients who left against medical advice during the first seven days were admitted on Friday. For more information, see the case study and change bulletin.

Lessons Learned

  • Make sure that clients can meet with their counselor and participate in structured activities during the first 24 hours after admission.

Tracking Measures

Cycle Measure

Dropout rate

Data Collection Form

Residential Dropout Tracking Spreadsheet



  • 1. Collect baseline data for the dropout rate for the first 30 days of residential treatment.


  • 2. For the next two-week period, do not admit any clients on Friday.
  • 3. Track and calculate the dropout rate.


  • 4. Check the fidelity of the change. Was the change implemented as planned?
  • 5. Evaluate the change: did the dropout rate decrease?


  • 6. Adjust the admit system and re-test this promising practice for an additional two weeks.

Repeat this series of steps until there are no Friday admissions.