Reducing direct-care staff absenteeism: effects of a combined reinforcement and punishment procedure

Absenteeism of 130 direct-care staff was reduced by 27% through a mixed consequence procedure consisting of positive reinforcement for reliable attendance and punishment (progressive discipline) for attendance abuse. Reduced rates of absenteeism were maintained over a 12-month period. A 17% reduction in overtime and an increase in annual staff turnover from 34% to 45% also occurred. Results extend the findings of mixed consequence procedures to residential facilities for persons with developmental disabilities. Development of a more powerful positive reinforcement component was discussed.