Derivaciones inadecuadas a las consultas de equilibrio de otorrinolaringología dirigidas por fisioterapeutas en Merseyside, Reino Unido: una auditoría retrospectiva mediante el ciclo Planificar-Hacer-Estudiar-Actuar (PHEA/PDSA).
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Introducción: Los síntomas de mareo y vértigo tienen una prevalencia del 10-30 % en el Reino Unido, y aproximadamente el 25 % de las derivaciones a otorrinolaringología (ORL) se deben a mareo o inestabilidad. Las derivaciones de baja calidad generan listas de espera cada vez más largas, lo que prolonga el tiempo hasta el diagnóstico y retrasa el tratamiento, con el consiguiente riesgo de desarrollar mareo crónico, inestabilidad y caídas. Objetivo: Realizar una auditoría retrospectiva para determinar la pertinencia de las derivaciones a las consultas locales de equilibrio de ORL dirigidas por fisioterapeutas. Método: Se llevó a cabo una auditoría retrospectiva, basada en el ciclo «planificar, hacer, estudiar, actuar» (PDSA), de las derivaciones y sus resultados diagnósticos. Resultados: Todas las derivaciones indicaban mareo, vértigo o inestabilidad como motivo de consulta; sin embargo, tras la evaluación, 21 de 100 se consideraron no pertinentes. Discusión: El proceso de derivación actual presenta limitaciones. Podría ser beneficioso desarrollar una vía clínica local estandarizada para el paciente con mareo, centrada especialmente en el abordaje de la hipotensión ortostática y la migraña vestibular en atención primaria. Conclusión: La hipotensión ortostática es la afección con mayor probabilidad de ser derivada de forma inadecuada.
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