title: Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient.
abstract: BACKGROUND
  Because of its multifaceted nature, dizziness is difficult for clinicians to diagnose and manage independently. Current treatment trends suggest that patients are often referred to the otolaryngologist for intervention despite having a nonotologic disorder. Additionally, many individuals with atypical presentations are often misdiagnosed and spend a significant amount of time waiting for consultation by the otolaryngologist. Few studies have alluded that implementation of an interprofessional team approach in the diagnosis and management of the dizzy patient can improve clinical decision-making. However, to the authors' knowledge, there is no information specifically quantifying the outcomes and potential benefits of using an interprofessional balance care team approach.
  
  
  OBJECTIVE
  To compare dizziness diagnoses trends and referral practices with and without the use of an interprofessional management approach within a university healthcare system.
  
  
  METHODS
  Over the course of a 3-yr period, a retrospective review of the diagnosis and management of dizziness was performed with and without implementation of an interprofessional team. To observe potential differences, year 3 incorporated the interprofessional management approach while years 1-2 did not. The two periods were then compared to each other.
  
  
  METHODS
  A total of 134 patients referred to a university hearing clinic for a vestibular and balance function evaluation.
  
  
  METHODS
  Diagnoses and management trends were examined with descriptive statistics (percentages and frequencies). Fisher's exact tests, analysis of contingency tables, were conducted to evaluate the influence of interprofessional management on dizziness diagnoses and treatment patterns.
  
  
  RESULTS
  Results demonstrated that before implementation of an interprofessional team approach, (1) referring clinicians used unspecific dizziness diagnosis codes (e.g., dizziness and giddiness), (2) a low number of patients with dizziness were referred for balance function testing, (3) diagnoses remained unspecific following the balance function assessment, and (4) the most frequently occurring vestibular diagnoses were unilateral vestibular hypofunction and benign paroxysmal positional vertigo. Following the use of an interprofessional management approach, it was determined that (1) disease-specific diagnoses increased, (2) patients with dizziness were referred for balance function testing mainly by otolaryngologists, (3) dizziness was considered to be multifaceted for a greater number of patients, (4) a larger percentage of patients were referred to a specialist other than the otolaryngologist as a result of their diagnosis, and (5) patients reported reduction or resolution of their symptoms.
  
  
  CONCLUSIONS
  An interprofessional management approach for the dizzy patient can lead to more specific diagnoses and provide alternative referral pathways to other health-care professionals (e.g., audiologists, physical therapists, and pharmacists) in an effort to reduce over-referral to one specialist. Future studies should address the utility of an interprofessional team approach in the overall management of patients with dizziness.
authors.affiliation: Department of Speech, Language & Hearing Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX.
authors.forename: Amanda I
authors.initials: AI
authors.lastname: Rodriguez
authors.affiliation: Department of Speech, Language & Hearing Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX.
authors.forename: Steven
authors.initials: S
authors.lastname: Zupancic
authors.affiliation: Department of Cell Biology and Biochemistry, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Song
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
authors.forename: Joehassin
authors.initials: J
authors.lastname: Cordero
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
authors.forename: Tam Q
authors.initials: TQ
authors.lastname: Nguyen
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, Texas Tech University Health Sciences Center, Lubbock, TX.
authors.forename: Charles
authors.initials: C
authors.lastname: Seifert
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods; D019468:Disease Management; D004244:Dizziness / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014717:Vertigo / Q000175:diagnosis / Q000628:therapy