Predicting Patient Needs for Interdisciplinary Services in a Voice and Swallowing Center.

In a subspecialty interdisciplinary voice and swallowing clinic, patient referrals come from a wide variety of disciplines for various reasons, which can make scheduling their initial evaluations challenging. Depending on the nature of complaints and symptoms, patients may best be evaluated either by a single provider (a laryngologist) or by an interdisciplinary team that includes a speech-language pathologist. If not scheduled appropriately, the provider and the patient may lose valuable time, resources, and money. This was a retrospective chart review of 76 patients who received an interdisciplinary evaluation in our Voice and Swallowing Center's first 7 months of operation. Two factors were examined for their predictive values: the most common reasons for referral and the disciplines that commonly refer to the clinic. The goal was to probe for any variables known at the time of referral that could inform us whether an interdisciplinary evaluation would be beneficial or not. This information informs resource planning for space, equipment, scheduling, and staffing. The results showed that the most common reasons for a referral to the Voice and Swallowing Center were dysphonia (34.8%), dyspnea/paradoxical vocal fold motion ("PVFM," 20.2%), and dysphagia (18%). Statistical analysis of the results indicated that certain reasons for referral were more likely to require an interdisciplinary evaluation than others: dysphonia, irritable larynx syndrome/chronic cough, and PVFM. Referrals most commonly came from providers with a background discipline of primary care (26%) and otolaryngology (22%). The discipline of a referring provider alone was not a strong enough indicator to reliably predict the type of evaluation needed. Examining the available data on referral patterns, as this study has done, has the potential to inform providers how to better anticipate their patients' needs and also improve clinic operations.
(Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)