An Assessment of the Management of Dizzy Patients in a Specialist
Multi-Disciplinary Clinic; The Impact of Effective Telephone Triage
Abstract
Objectives Dizziness has a lifetime prevalence of 17 – 30%. These
symptoms have multiple aetiologies and can be difficult to diagnose in a
routine ENT clinic. Several units have established multi-disciplinary
‘Dizzy Clinics’ to standardise the management of complex patients. We
have developed a multi-disciplinary ‘Dizzy Clinic’ comprising clinicians
and allied healthcare professionals, which incorporates a telephone
triage service. Our service has been radically changed to triage
patients to either a rapid access 30-minute BPPV clinic, or a 1-hour
complex balance clinic and this study assesses the efficacy of our new
model. Methods We conducted a retrospective audit of 124 patients
referred to ‘generic’ ENT clinics for dizziness in 2019. This data was
used to implement a new service where patients would receive a telephone
triage before progressing to a multi-disciplinary clinic comprising
audiologists, physiotherapists, and ENT surgeons. We prospectively
re-audited 151 patients referred to this service in 2021. Results 40%
of patients referred with dizziness in 2019 did not require a
face-to-face appointment for an assessment of their dizziness. A
telephone triage introduced to our ‘Dizzy Clinic’ streamed only 35.8%
of referrals to a face-to-face appointment. 90% of face-to-face
appointments from the ‘Dizzy Clinic’ were performed by a non-ENT
surgeon. The ‘Dizzy Clinic’ showed more thorough and improved
examinations compared to the previous cycle, and 60% were discharged
from the ‘Dizzy Clinic’ after their first assessment, compared to 61%
in the previous cycle. Conclusions Our ‘Dizzy Clinic’ effectively
triages patients and enables a multi-disciplinary team to contribute to
the management of dizzy patients.