Process improvement for behavioral health

Eliminate the Blackout Period


Clients leave treatment because they feel isolated from family and friends.


Eliminate “blackout” period for phone calls and visitors.

Featured Stories

Fayette Companies in Peoria, Illinois, reduced discharges against medical advice within the first 7 days from 21 percent to 5 percent by eliminating the “blackout” week for phone calls and visitors and making other changes. For more information, see the Fayette Case Study and the Fayette Change Bulletin

Lessons Learned

  • Allowing clients to stay in touch with family members and friends while in residential treatment can improve outcomes.
  • Clients who feel isolated may be at risk for leaving treatment against medical advice.

Tracking Measures

Cycle Measure

Dropout rate

Data Collection Form

Residential Dropout Tracking Spreadsheet



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


2. For the next two-week period, eliminate the blackout period.

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?
    • Was it necessary to supervise phone calls?


6. Adjust system for making contact with loved ones and supervision during phone calls and re-test this promising practice for an additional two weeks.

7. Repeat this series of steps until you have established clear policies that allow elimination of the blackout period.