Leading from the Middle: Replication of a Re-Engagement Program for Veterans with Mental Disorders Lost to Follow-Up Care

Table 5

Barriers and solutions related to appointment attendance following outreach contact.

Barriers	Solutions
(1) Service chiefs are reluctant to prioritize spots to re-engagement patients	(1) Emphasize incentives for timely appointments
(2) Difficult to achieve timely referral appointments for chronically backlogged services	(2a) Coordinate referrals through integrated care teams to increase ability to deliver immediate care
	(2b) Set up appointments between patient and outreach provider as a last resort
(3) Patients have difficulty attending appointments due to transportation issues (e.g., rural settings)	(3a) Proactively identify and coordinate resource to address logistical barriers (e.g., transports) to support referral uptake
	(3b) Outreach staff work with patients to identify and problem-solve logistical issues related to appointment attendance
(4) Coordinating referrals, appointments, and follow up with distant facilities can be challenging	(4a) Establish within network referral protocols and network with other points of contact to facilitate patient re-engagement
	(4b) Re-engagement staff directly facilitate the scheduling of appointments between patients and needed clinics
	(4c) Clearly document appointments and referrals within VA electronic medical record