Absenteeism in Health Care: Using Interlocking Behavioral Contingency Feedback to Increase Attendance With Certified Nursing Assistants

Abstract

This research used an ABA multiple baseline design across hospitals to evaluate a behavioral intervention designed to reduce absenteeism among 64 certified nursing assistants (CNA) in a rural health care organization. Pre-baseline assessments suggested that when CNAs were absent from work, other employees had to work unscheduled shifts. Because of this metacontingency, employees reported that they skipped work themselves to make up for the extra shifts they had to cover. This cycle created more unscheduled shifts and potentially caused the high absenteeism prevalent at the organization. An intervention with normative and metacontingency feedback significantly decreased the total number of days CNAs were absent per week across the three hospitals from a baseline mean of 0.24 (SD = 0.19) days per week (7.74% of their scheduled hours) to a mean of 0.13 (SD = 0.17) days per week (3.81% of their scheduled hours) during the intervention. In a return to baseline the total number of days CNAs were absent per week across the three hospitals increased to a mean of 0.24 (SD = 0.20) days per week (7.47% of their scheduled hours).

Keywords:

• absenteeism
• metacontingency
• normative feedback