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Diagnosis (Berl) . Author manuscript; available in PMC: 2017 Jul 27. Published in final edited form as: Diagnosis (Berl). 2016 May 31;3(2):49–59. doi: 10.1515/dx-2016-0009 Diagnosis is a team sport – partnering with allied health professionals to reduce diagnostic errors A case study on the role of a vestibular therapi... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.575 | 0.862 | ["philosophy", "management", "career", "education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.680070 | [
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s by David E Newman-Toker * Author information Article notes Copyright and License information * Corresponding author: David E. Newman-Toker, MD, PhD, Associate Professor, Department of Neurology and Otolaryngology, The Johns Hopkins University School of Medicine, CRB-II, Room 2M-03 North 1550 Orleans Street, Baltimore... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.53 | 0.832 | ["education", "philosophy"] | 491 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.680694 | [
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and Hospitals, Raleigh Campus, Raleigh, NC, USA. http://orcid.org/0000-0002-4194-4740 Issue date 2016 Jun. PMC Copyright notice PMCID: PMC5532056 NIHMSID: NIHMS877539 PMID: 28758055 The publisher's version of this article is available at Diagnosis (Berl) Abstract Background Diagnostic errors are the most common, most c... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.645 | 0.836 | ["management"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.681040 | [
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ltural barriers may impact the engagement of allied health professionals (AHPs) in the diagnostic process. Methods A qualitative case study of the experience at a single institution around involvement of an AHP in the diagnostic process for acute dizziness and vertigo. We detail five diagnostic error cases in which the... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.421 | 0.856 | ["career", "education"] | 504 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.681377 | [
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tution as relates to AHP engagement in diagnosis. Results Five patients with acute vestibular symptoms were initially misdiagnosed by physicians and then correctly diagnosed based on input from a vestibular physical therapist. These included missed labyrinthine concussion and post-traumatic benign paroxysmal positional... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.465 | 0.816 | [] | 441 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.681497 | [
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called BPPV; and multiple sclerosis called BPPV. As a consequence of surfacing these diagnostic errors, initial resistance to physical therapy input to aid medical diagnosis has gradually declined, creating a more collaborative environment for ‘team diagnosis’ of patients with dizziness and vertigo at the institution. ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.481 | 0.832 | ["management", "economy"] | 482 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.681632 | [
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gnosis as something reserved only for physicians. Drawing attention to the valuable diagnostic contributions of AHPs may help facilitate cultural change. Future studies should seek to measure diagnostic safety culture and then implement proven strategies to breakdown sociocultural barriers that inhibit effective teamwo... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.468 | 0.828 | ["management"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.681761 | [
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duction Diagnostic errors are the most common, most costly, and most catastrophic of medical errors [ 1 – 4 ]. A recent national academy of medicine (NAM, formerly Institute of Medicine [IOM]) report on Improving Diagnosis in Healthcare estimated that every American will experience at least one diagnostic error in his/... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.428 | 0.83 | ["philosophy"] | 418 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.681978 | [
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nces such as permanent disability or death [ 5 ]. Building on patient safety principles developed in tackling therapeutic errors, the NAM committee placed strong emphasis on teamwork to improve diagnosis, making their first overall recommendation to “facilitate more effective teamwork in the diagnostic process among he... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.559 | 0.846 | ["management", "career", "communication", "economy", "rhetoric"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682154 | [
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gnosis to include nurses, therapists, and other allied health professionals: “The diagnostic process hinges on successful intra- and interprofessional collaboration among health care professionals, including primary care clinicians, physicians in various specialties, nurses, pharmacists, technologists, therapists, soci... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.549 | 0.82 | ["career", "communication", "management", "economy", "rhetoric"] | 477 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682300 | [
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d and supported to engage in diagnostic teamwork. The roles of some health care professionals who participate in the diagnostic process have been insufficiently recognized… nurses are often not recognized as collaborators in the diagnostic process, despite their critical roles in ensuring communication, care coordinati... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.468 | 0.842 | ["communication", "management", "career", "economy", "education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682430 | [
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sis is historically and legally considered a physician’s responsibility. Allied health professionals (AHPs) such as nurses, speech language pathologists, and physical therapists (PTs) are often prohibited from making medical diagnoses as part of the legal definitions of their respective scopes of practice. Although cer... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.491 | 0.838 | ["career", "social_justice", "rhetoric"] | 502 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682626 | [
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nstraints may limit their role in diagnosis (e.g. only narrowly-defined “nursing diagnoses” or assessment of “minor” medical symptoms). There are reasons to believe, however, that this antiquated view of medical diagnosis needs to change. First, diagnostic reasoning is already a core job responsibility for most AHPs, e... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.444 | 0.826 | ["philosophy", "career"] | 413 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682696 | [
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such as “triage” or “assessment of functioning”. When a nurse “triages” a patient in the emergency department (ED) or decides whether to call the surgeon to evaluate an ill-appearing post-operative patient, he uses symptoms and signs to determine a patient’s level of illness. When a speech pathologist determines the ph... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.426 | 0.83 | ["philosophy", "decision_making", "crisis", "rhetoric"] | 438 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682763 | [
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rinciples to determine the nature of dysfunction. When a vestibular PT identifies which semicircular canals require treatment in benign paroxysmal positional vertigo (BPPV), he uses physical diagnosis skills to differentiate one vestibular disorder from another. These are all examples of applied diagnostic reasoning th... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.541 | 0.832 | ["philosophy", "management", "education"] | 455 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682819 | [
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pend more time with a patient than the physician. They may see patients repeatedly to check on them as inpatients or follow them routinely over time as outpatients. This means that AHPs often have greater exposure to the range of patient symptoms, disease course, and response to therapy, all of which may offer addition... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.406 | 0.862 | ["education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682874 | [
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for the purposes of diagnosis needlessly reduces the quality of care and may perpetuate misdiagnoses. Finally, as medical knowledge becomes increasingly subspecialized, many AHPs now have considerably more expertise than their physician counterparts within their narrow domains of practice. One such domain is the evalua... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.363 | 0.84 | ["education"] | 477 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682926 | [
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patients with BPPV and other inner ear disorders. Dizziness and vertigo lead to more than 12 million medical visits each year in the US [ 6 , 7 ]. As dizziness and vertigo are among the most misunderstood and commonly misdiagnosed symptoms in all of medicine [ 8 – 15 ], it is not uncommon for referred patients to have ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.535 | 0.854 | [] | 443 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.682976 | [
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e patient care may lead directly to misdiagnosis. In this article we describe a series of five cases presenting dizziness or vertigo in which initial physician diagnoses were not supported by the results of detailed vestibular examinations performed by a vestibular PT. The input provided by the therapist to the physici... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.447 | 0.832 | ["philosophy"] | 421 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683053 | [
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equently, changes in the care that was delivered. We discuss the immediate implications of this case series for optimizing diagnosis of patients with dizziness and vertigo, as well as the broader issue of engaging AHPs in diagnosis across a range of conditions. Methods This qualitative case study describes an ongoing i... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.374 | 0.858 | ["education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683102 | [
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e with several groups of physicians in a single medical center from 2011 to 2016. As part of this institutional case study, we report a retrospective, nonconsecutive case series of patients presenting with acute dizziness or vertigo who were initially misdiagnosed by physicians and later correctly diagnosed after consi... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.385 | 0.858 | ["education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683173 | [
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ical center with respect to the value placed on physical therapy vestibular examination findings to help with accurate diagnosis. These changes have been coincident with (and perhaps the result of) a series of formal and informal interactions between the PT and physicians as well as mid-level providers. Note that we ha... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.562 | 0.834 | ["philosophy"] | 443 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683220 | [
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vidual patient or physician discovery by readers. This study was evaluated by the WakeMed Health and Hospitals Institutional Review Board (IRB) and was determined to be exempt from formal IRB review (IRBNet#745256-1). The PT, with over 24 years’ experience and a certificate of competency in vestibular rehabilitation, h... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.377 | 0.84 | ["education", "philosophy"] | 474 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683276 | [
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ess and vertigo in the ED and acute care setting. The subspecialist neuro-otologist has completed neurology residency (4 years), followed by fellowships in neuro-ophthalmology (1 year) and neuro-otology (2 years). The focus of his clinical practice and research is improving diagnostic accuracy and reducing diagnostic e... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.36 | 0.84 | ["education"] | 468 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683342 | [
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ears’ experience since graduating medical school. The medical center is a large, acute care trauma center and tertiary care hospital. The PT interacts with a mix of physicians and mid-level providers, most commonly hospitalists and internal medicine residents, neurologists and neurological PAs, trauma surgeons and surg... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.386 | 0.844 | ["education"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683389 | [
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urology practitioners, but sometimes by ED staff. Once patients have been admitted to observation or inpatient status, referrals may be generated by any of the above-listed providers, or may be prompted by other physical or occupational therapists identifying the need for vestibular evaluation during routine therapy se... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.546 | 0.852 | [] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683440 | [
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his articles describing a novel bedside method (called ‘HINTS’) for differentiating strokes from inner ear diseases using eye movement exams in patients presenting acute dizziness and vertigo [ 16 ]. The original email, included as an online supplement , makes clear the fundamental dilemma that Dana faced as an AHP. Sh... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.37 | 0.846 | [] | 451 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683483 | [
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any documentation that would insinuate diagnosis. I will, in verbal conversations with physicians, at their requests, give them my opinion, based on objective examination findings. I have referred to the HINTS article on several occasions, in hopes of finding physicians who are aware of its huge implications. Most are ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.573 | 0.852 | ["war_conflict", "communication"] | 494 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683533 | [
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d an ongoing channel of communication was opened. Dana would periodically discuss difficult vestibular cases with David, but also difficult interactions with other providers. Some were skeptical of her knowledge base or questioned her authority to provide them with diagnosis-relevant clinical information. David served ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.58 | 0.848 | ["crisis", "communication", "education", "philosophy"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683657 | [
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cases demonstrating diagnostic errors that were prevented by a clarified “team” approach to diagnosis of these patients. These five are representative of a multitude of cases at the medical center where vestibular assessments provided by vestibular PTs have provided substantive information to assist with diagnosis. In ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.597 | 0.834 | ["management", "philosophy"] | 472 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683774 | [
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dered input from the physical therapy assessment. One case was admitted and discharged by the trauma service (Case 1). Four cases were admitted and discharged by hospitalists (Cases 2, 3, 4, 5) and two of those cases included the addition of neurology consultation for therapeutic intervention following a correctly iden... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.55 | 0.858 | [] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683881 | [
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responding implications for both diagnostic costs (test overuse) and patient safety (health outcomes). The outcome of this team diagnostic process in each case resulted in effective treatment for the conditions ultimately correctly diagnosed, timely discharge from the acute care setting, and patient satisfaction that t... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.616 | 0.826 | ["communication", "management"] | 464 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.683998 | [
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lures in five cases presenting dizziness/vertigo. Case # Initial incorrect diagnosis Correct/additional diagnosis Misdiagnosis type a Diagnostic process error stage b 1 None Traumatic BPPV, right cochleo-labyrinthine concussion Low quality 2, 3 2 Gastroenteritis BPPV Low quality, high cost 1, 2, 3 3 Stroke BPPV Low qua... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.532 | 0.718 | [] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.684120 | [
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nign paroxysmal positional vertigo; VAD, vertebral artery dissection. a Misdiagnosis type=dangerous (emergent condition called non-urgent/benign); high cost (non-urgent called emergent with resulting unnecessary testing), low quality (one non-urgent condition mistaken for another; missed second non-urgent diagnosis). b... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.386 | 0.676 | ["philosophy"] | 505 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.684252 | [
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on; 4. test ordering; and 5. test interpretation. Case #1: A young adult fell off the back of a truck, sustaining head trauma A head computed tomography (CT) obtained in the ED was negative for brain bleed, contusion, or edema. High-resolution CT of the temporal bones showed all inner ear structures intact. The patient... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.519 | 0.848 | [] | 466 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.684358 | [
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d right mastoid fractures, along with concussion. The PT’s evaluation, including the evidence-based HINTS [ 16 – 20 ] eye exam, revealed subtle direction-fixed left-beating nystagmus with mildly abnormal right horizontal head-impulse test but no vertical skew deviation on alternate cover test, suggesting an acute right... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.348 | 0.854 | [] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.684499 | [
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ee right semicircular canals on positional testing. The PT treated the patient’s BPPV successfully using a sequence of multiple different canalith repositioning maneuvers. All of the positional testing for BPPV was negative on the second day. The patient was independently ambulating without assistive devices and demons... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.529 | 0.844 | [] | 488 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.684766 | [
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vestibular exercises to continue after discharge. The PT spoke with the trauma PA about the exam findings, adding the following new diagnoses: acute right cochleo-vestibulopathy (likely from labyrinthine concussion, which cannot be detected by CT) and multi-canal post-traumatic BPPV, treated effectively by evidence-bas... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.536 | 0.83 | [] | 447 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.685320 | [
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t audiogram to assess the degree of hearing loss. Case #2: An elderly patient with mild dementia was admitted with symptoms of intractable nausea and vomiting The patient was diagnosed with gastroenteritis by the admitting hospitalist. During a routine physical therapy evaluation, the patient’s family member mentioned ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.536 | 0.852 | ["family"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.685779 | [
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right posterior canal BPPV on Dix-Hallpike testing, which was treated with a single canalith repositioning maneuver [ 21 , 22 ]. The patient had significant vegetative symptoms (i.e. nausea and dry heaving, diaphoresis) at the time of treatment. The PT spoke with the attending hospitalist and conjectured that the nause... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.52 | 0.86 | [] | 503 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.685907 | [
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ted the diet with no further nausea and vomiting. The next day, the patient was asymptomatic and walking well with the family as per the reported baseline. A repeat Dix-Hallpike test was negative for vertigo or nystagmus. The final diagnosis by the treating physicians was BPPV, not gastroenteritis. Case #3: A middle-ag... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.535 | 0.838 | ["management", "family"] | 445 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.685961 | [
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list internal medicine team diagnosis was stroke. Magnetic resonance imaging (MRI) brain was negative for acute changes. The PT’s evaluation revealed symptoms and signs consistent with right horizontal and posterior canal BPPV. The patient reported a lifelong history of a tendency toward motion sensitivity. At the time... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.553 | 0.846 | ["management", "war_conflict"] | 497 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686013 | [
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walk 25 feet and required significant assistance. After 2 days of treatment with multiple canalith repositioning maneuvers, the patient had complete resolution of the right posterior canal BPPV and partial resolution of the right horizontal canal BPPV. At the time of discharge, the patient was walking 100 feet with onl... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.515 | 0.84 | [] | 482 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686056 | [
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ibular rehabilitation to continue BPPV treatment. PT examination findings and treatment results were discussed directly with the medicine team on both days directly following physical therapy sessions. The final diagnosis by the physician team was BPPV. Case #4: A middle-aged patient presented with symptoms of nausea, ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.354 | 0.85 | ["management"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686109 | [
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ysical therapy evaluation the next morning due to constant, severe vertigo and nausea. The PT’s interview of the patient revealed a history of head and neck trauma during a work-related incident a few weeks prior. The patient endorsed a few episodes of intermittent vertigo and right ear tinnitus since the trauma, and a... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.416 | 0.866 | ["interview"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686158 | [
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diagnosis, given the patient’s trauma history and constant (non-episodic) vertigo, two important markers of stroke risk [ 17 , 23 ]. Based on the PT’s concern and the PT’s assertion that the signs and symptoms exhibited by the patient were not consistent with BPPV, the physician ordered neuroimaging [MRI and magnetic r... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.514 | 0.848 | [] | 510 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686203 | [
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onsulted and prescribed anticoagulant medication. There was no stroke progression or worsening. The patient’s gait and balance improved over the next few days of acute hospital physical therapy treatment. The patient was transferred to an inpatient rehabilitation hospital for ongoing therapy prior to discharge home. Ca... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.533 | 0.854 | ["family"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686251 | [
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ng of unsteady gait and mild vertigo upon presentation to the ED The ED physician ordered a CT scan of the head, which was normal. The ED staff handed the patient over to the hospitalist, who called the vestibular PT and asked that the patient be assessed for BPPV. The PT’s evaluation revealed subtle neurologic signs n... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.414 | 0.858 | ["communication"] | 478 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686298 | [
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ar foot numbness, and mild left tongue deviation. The HINTS exam, also performed by the PT, revealed direction-changing horizontal nystagmus in right and left gaze, normal horizontal head-impulse test bilaterally, and no vertical skew deviation on alternate cover test. The PT’s assessment stated concern for central ves... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.534 | 0.856 | ["philosophy"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686351 | [
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tely with the physician by phone, the physician ordered a brain MRI, which revealed multiple bilateral cerebral hemisphere and brainstem lesions consistent with multiple sclerosis, the final diagnosis. The patient was admitted and received IV steroid treatments per recommendations of the Neurology team, with plans for ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.545 | 0.824 | ["management"] | 445 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686401 | [
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dependently ambulating without assistive devices. The patient had residual subtle high-level balance deficits, but was not at risk for falls. The patient was given a home balance exercise program. Sociocultural and structural changes in ‘team diagnosis’ over time at the medical center The climate of discourse between D... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.636 | 0.848 | ["management", "family"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686455 | [
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clinical findings were incompatible with the initial medical diagnosis. Due to widely accepted sociocultural norms with respect to physician-AHP interactions, she has felt it necessary to tread very lightly or back down on many occasions. These interactions have often placed Dana in an ethical and moral bind, trapping ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.415 | 0.826 | ["ethics"] | 427 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686504 | [
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cal and personal obligation to help her patients. Despite continued resistance to optimal collaboration by some providers, she feels that the environment has improved and more practitioners are becoming receptive, as she and her team of PTs who perform vestibular evaluations and treatments continue to demonstrate the v... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.398 | 0.858 | ["philosophy", "communication", "management", "economy", "rhetoric"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686565 | [
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ecially in the early years of this transformation, when resistance was particularly strong. There was a major nodal point in transforming the sociocultural milieu. This occurred when Dana presented at medical grand rounds to an audience consisting of mostly physicians, discussing the clinical assessment and treatment o... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.571 | 0.846 | ["philosophy"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686639 | [
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ar evaluation in achieving accurate diagnoses in these patients. Another breakthrough came when she was asked to present at a morbidity and mortality case conference. In this case (Case 4), the patient was initially misdiagnosed by physicians as having BPPV but, because of Dana’s attention to relevant history and sympt... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.429 | 0.86 | ["philosophy"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686739 | [
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ction between Dana (along with her vestibular physical therapy team) and the treating physicians has changed substantially. A number of physicians have begun to rely on input from the physical therapy vestibular assessment more proactively, rather than waiting for the therapists to retroactively notify them that their ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.559 | 0.846 | ["management"] | 497 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686862 | [
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” (i.e. a specific treatment maneuver for BPPV)]. Some physicians have even allowed Dana to educate them at the bedside in vestibular clinical skills, and have begun to incorporate vestibular exam skills into practice when admitting patients with vertigo and dizziness. One such physician reported that she was able to c... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.534 | 0.834 | [] | 429 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.686966 | [
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n finding in a patient with a negative brain MRI. The physician, realizing that the exam indicated central vestibular pathology despite the negative MRI, ordered an MRA, which showed vertebral artery dissection. The physician indicated that prior to being educated by Dana in how to execute the HINTS exam, this would ha... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.415 | 0.862 | [] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.687094 | [
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uch as migraine or inner ear disease, preventing her from seeking out more dangerous causes. Over several years, Dana has been able to successfully build trusting relationships with many physician colleagues, who now routinely consider and use her clinical findings to inform subsequent diagnostic or management decision... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.39 | 0.834 | ["management", "decision_making", "networking", "philosophy"] | 422 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.687224 | [
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practice setting are shown in Table 2 . Table 2. Sociocultural changes and improved patient outcomes noted over time through interaction between an AHP (vestibular PT) and medical colleagues around diagnosis of patients with dizziness. Increased recognition by medical staff of potential vestibular pathology in patients... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.57 | 0.846 | [] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.687330 | [
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assisting medical staff to reach an accurate diagnosis, including medical diagnoses (e.g. stroke) Increased recognition of the effectiveness of appropriately trained PTs in treating BPPV PT consults now often ordered with designation of “vestibular evaluation and treatment” (rather than “treat BPPV”) so that patients a... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.599 | 0.846 | [] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.687435 | [
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appropriately trained PT staff are consulted Increased patient/caregiver satisfaction that the chief complaint is being addressed and managed appropriately Increased appropriate referrals to outpatient vestibular rehabilitation Open in a new tab BPPV, benign paroxysmal positional vertigo; PT, physical therapist. Discus... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.555 | 0.698 | ["communication", "education"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.687555 | [
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stibular PT) in diagnosis of a single problem (dizziness/vertigo) at a single-center. This case study reinforces and illustrates three domain-specific points that have been made previously in the literature: (1) misdiagnosis of dizziness by frontline physicians is a common problem [ 14 , 15 ]; (2) many vestibular physi... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.539 | 0.71 | ["education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.687690 | [
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ublishing articles [ 25 , 26 ] and teaching courses [ 27 ] almost identical to those for physicians specializing in dizziness or vertigo; (3) vestibular PTs must currently play a ‘shadow’ role in diagnosis, because of both scope-of-practice legal constraints and related sociocultural barriers [ 28 ]. The importance of ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.434 | 0.724 | [] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.687830 | [
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pecialty physicians in the US focused on diagnosing vestibular disorders (est. <250), and the greater numbers of PTs with relevant sub-discipline training (est. >4000). These issues point to the need for a dedicated effort to deliberately engage vestibular PTs as part of a team diagnostic process in dizziness and verti... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.566 | 0.826 | ["management"] | 428 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.687977 | [
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ates have expressly prohibited medical diagnosis. Though most PTs strive to avoid frank medical diagnosis, some find themselves in the position of providing vital information that influences diagnosis. Many PTs have developed strong physical examination and interview skills, coupled with high levels of anatomy and phys... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.583 | 0.852 | ["interview", "education", "philosophy"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688102 | [
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not) consistent with the physician’s initial medical diagnosis. Effective communication and teamwork between PTs and medical practitioners in these cases may help to increase the likelihood of accurate diagnosis, and subsequently, appropriate treatment interventions. A ‘team diagnosis’ approach can be very effective if... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.648 | 0.84 | ["management", "communication"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688190 | [
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y evaluation and input from other AHPs, as illustrated in this case study. The role of all AHPs in diagnosis, more generally These domain-specific points described here may generalize to other clinical circumstances, in which AHPs, by virtue of their specialized training and roles in assessing patient function, are wel... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.577 | 0.834 | ["ethics", "education", "philosophy"] | 453 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688304 | [
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he physicians legally responsible for diagnosis). Other examples include the following: (1) a speech therapist’s role in diagnosing uncommon causes of dysphonia, such as myasthenia gravis [ 29 ]; (2) an audiologist’s role in diagnosing the underlying cause of tinnitus [ 30 ]; and (3) a nurse’s role in risk assessment a... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.433 | 0.864 | ["strategy", "rhetoric"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688408 | [
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, it is relatively rare in clinical practice to see physicians willing to routinely engage AHPs in differential diagnostic discussions or decisions regarding further diagnostic testing. In countering our contention of generalization beyond dizziness, some might claim that diagnosis of dizziness and vertigo is truly a s... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.535 | 0.852 | ["decision_making", "education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688501 | [
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of when to obtain neuroimaging for patients looking for serious neurologic causes a top priority for development of clinical decision rules [ 32 ]. Numerous studies have identified knowledge gaps [ 9 , 10 , 33 ], evidence-practice gaps [ 11 , 13 , 14 ], frequent diagnostic errors [ 12 , 34 , 35 ], and poor patient outc... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.389 | 0.88 | ["education", "decision_making"] | 491 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688591 | [
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generally covered in medical school or residency. However, dizziness is not unique in this regard. For example, similar issues have been identified for diagnosis of visual symptoms, including recognition of critical findings in the optic fundus, such as papilledema [ 39 ]. This is a skill not well taught (or learned) i... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.487 | 0.854 | ["education", "war_conflict"] | 462 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688702 | [
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linical practice settings, such as the ED [ 39 ]. By contrast, optometrists are extensively trained in recognition of papilledema and differentiation of mimics [ 41 ]. Recommendations for “transdisciplinary team diagnosis” The purpose of this manuscript is not to recommend that we supplant physician diagnoses with AHP ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.465 | 0.852 | ["management"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688790 | [
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that barriers to effective “team diagnosis” ( Table 3 ) are important patient safety risks. In therapeutic domains, communication and teamwork have been identified as critical patient safety factors [ 42 ]. Studies have recently begun to appear that demonstrate benefits of teamwork for diagnostic safety [ 43 ]. Some ad... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.517 | 0.858 | ["management", "communication", "salary"] | 485 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688891 | [
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tages of engaging AHPs in the diagnostic process. Primary barriers to engaging AHPs in diagnosis Primary advantages of engaging AHPs in diagnosis – Logistical (e.g. many clinics separate AHPs from physicians in the outpatient setting, segregating diagnosis by physicians from treatment by AHPs) – Often greater availabil... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.556 | 0.684 | [] | 464 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.688967 | [
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-otologists) – Regulatory/scope of practice (e.g. nursing codes of ethics and legal constraints prevent them from rendering medical diagnoses; the same is true of many other AHP groups) – More time with the patient (e.g. nurses caring for post-operative patients on an inpatient surgical ward are with patients for exten... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.557 | 0.836 | ["communication", "ethics", "war_conflict", "rhetoric"] | 439 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689057 | [
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ne when physicians may not) – Sociocultural (e.g. hierarchical structure of physician-AHP relationships in which diagnosis is perceived as a skill ‘beyond’ AHPs) – Specialized expertise in diagnosis (e.g. speech-and-language pathologists in the evaluation and treatment of swallowing disorders) Open in a new tab AHP, al... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.575 | 0.842 | ["networking", "career", "rhetoric"] | 487 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689150 | [
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activity of the master physician clinician (e.g. the American TV show “House”), but, as articulated by Don Berwick, former president of the Institute for Health-care Improvement, “Genius diagnosticians make great stories, but they don’t make great health care. The idea is to make accuracy reliable, not heroic” [ 44 ]. ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.422 | 0.866 | ["philosophy", "management", "education"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689247 | [
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fective sharing of information and knowledge to improve accuracy of diagnosis. While “multidisciplinary” teams have been engaged in cancer diagnosis for decades, these teams are primarily composed of different physician specialties [ 46 ]. Interdisciplinary (rather than multispecialty) teams that engage AHPs as partner... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.452 | 0.846 | ["management", "education", "philosophy"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689370 | [
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al frameworks beyond the disciplinary perspectives, is likely very rare in current clinical practice. Table 4. Definitions of key terms related to teamwork, listed from least to most collaborative [ 47 ]. Intradisciplinary: working within a single discipline Crossdisciplinary: viewing one discipline from the perspectiv... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.595 | 0.834 | ["education", "management", "economy"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689472 | [
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nary: integrating knowledge and methods from different disciplines, using a real synthesis of approaches Transdisciplinary: creating a unity of intellectual frameworks beyond the disciplinary perspectives Open in a new tab There are obviously important legal scope-of-practice barriers to full integration of AHPs in cli... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.555 | 0.832 | ["governance", "education"] | 487 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689568 | [
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only a narrowly constructed diagnostic framework. It is unrealistic to imagine these legal regulations will change quickly (if at all), but this is probably not necessary for effective team diagnosis, as there is no prohibition on AHPs sharing opinions with physicians. Instead, what is critical to overcome are logistic... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.46 | 0.848 | ["management"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689684 | [
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ons where their diagnostic expertise could benefit the patient; (2) methods or venues to effectively communicate for the purpose of true transdisciplinary “team diagnosis” should be developed; and (3) sociocultural change should be deliberately cultivated. This third point, strongly recommended in the NAM report on Imp... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.505 | 0.834 | ["communication", "management"] | 447 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689811 | [
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change required is for both physicians and AHPs. Physicians will need to initiate a respectful dialog with AHPs to solicit their input regarding diagnosis, and AHPs will need to move beyond fears of overstepping their “station” by sharing diagnostic information with physicians. For example, it is notable that articles ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.448 | 0.858 | ["philosophy"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689907 | [
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describing how to diagnose and treat benign positional vertigo and other vestibular disorders [ 48 ]. The international consensus curriculum for vestibular PTs is no exception, explaining that therapists should “evaluate, treat, and manage care of patients with vestibular disorders” and be educated regarding “the proce... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.384 | 0.698 | [] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.689984 | [
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although actually making a diagnosis is outside the scope of practice…” [ 28 ]. Culture change around diagnosis will not be easy, but, fortunately, there are prior successful models of how it may be accomplished. Table 5 draws some explicit parallels between team therapy and team diagnosis, using specific examples [ 49... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.477 | 0.854 | ["management"] | 485 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690087 | [
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for diagnostic safety, using specific exemplars. Stage in safety culture and teamwork transformation Now: Therapeutic (CLABSI) [ 49 , 50 ] Future: Diagnostic (missed stroke in acute dizziness and vertigo) Safety leaders introduce team concept for safer care with a specific issue where there are known errors and harmful... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.477 | 0.858 | ["management", "leadership", "career", "philosophy"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690177 | [
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tell a physician how to do their job?”) ED nurses completely unwilling to even consider ‘interfering’ with ED physician diagnostic processes (“How can we tell a physician how to do their job?”) Appeal to patient-centeredness by safety leaders (“If the patient’s health is your ‘north star’, how can you stand by and know... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.581 | 0.858 | ["career", "leadership"] | 510 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690270 | [
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heter insertion protocols, but fear repercussions given the hierarchical relationships ED nurses consider the possibility of engaging the physician around dizziness diagnosis protocols, but fear repercussions given the hierarchical relationships Top-level leadership buy-in and support from the outset (Department or Div... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.492 | 0.708 | ["leadership", "networking", "strategy", "management"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690388 | [
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2 AM, and I will make it clear to them what I expect.”) ICU nurses begin intervening when physicians do not follow sterile precautions checklists during line insertion – “Doctor, shouldn’t we use a full-body sterile drape, as in the protocol?” (it is not important that nurses do not know how and are not allowed to inse... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.555 | 0.872 | [] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690465 | [
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going to examine the patient’s eyes before ordering neuroimaging, as in the protocol?” (it is not important that nurses do not know how and are not allowed to diagnose dizziness themselves) Feedback enhances individual and team calibration (adjusting their approach to diagnosis using prior performance in diagnostic acc... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.618 | 0.702 | ["management", "philosophy"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690552 | [
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sdisciplinary team processes to create new interventions that reduce catheter sepsis even further; success creates a virtuous cycle ED teams monitor rates of dizziness and stroke misdiagnosis and engage in transdisciplinary team processes to create new interventions that reduce misdiagnosis even further; success create... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.622 | 0.672 | ["management"] | 448 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690640 | [
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eam infection, a healthcare associated infection. Finally, as a case study, these findings are hypothesis generating, and suggest there may be value in more formally studying the role of AHPs in the diagnostic process. Only a handful of prior studies have looked at the impact of personnel changes on diagnostic safety, ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.574 | 0.83 | ["education", "philosophy"] | 413 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690742 | [
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interventions to reduce diagnostic error [ 51 ]. To our knowledge, only one research study has directly examined the role of AHPs in diagnosis (a single-center randomized trial showing no difference in emergency nurse practitioners’ accuracy to that of junior doctors) [ 52 ]. Future research should specifically study t... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.403 | 0.852 | ["education", "crisis"] | 490 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690846 | [
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s in diagnosis across a wide range of conditions. Limitations This was a qualitative, self-report study from a single care provider, dealing with a single clinical problem, at a single institution. The case sample is small, and may not be representative. Results may not generalize to other providers, problems, or setti... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.511 | 0.862 | ["management", "education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.690947 | [
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otentially devastating consequences for their patients. In the specific case of dizziness and vertigo, it should be routine practice to engage knowledgeable vestibular PTs in the diagnostic process, especially when appropriate medical subspecialty expertise is not immediately available (which is most of the time). Barr... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.488 | 0.828 | ["management", "education"] | 466 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.691060 | [
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gnosis as something reserved only for physicians. Drawing attention to the valuable diagnostic contributions of AHPs may help facilitate cultural change. We must break down sociocultural barriers to engaging AHPs in team diagnosis, in order to help minimize the risks of physician misdiagnosis. Engagement of physician c... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.469 | 0.84 | ["management"] | 511 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.691165 | [
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ural barriers that inhibit effective teamwork and transdisciplinary diagnosis. The impact of AHPs on diagnostic accuracy should be studied across a wide range of problems. Supplementary Material Appendix 1 NIHMS877539-supplement-Appendix_1.pdf (105.3KB, pdf) Acknowledgments Research funding: Preparation of this manuscr... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.49 | 0.828 | ["communication", "management"] | 490 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.691279 | [
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er Communication Disorders (1 U01 DC013778-01A1). The funding agency was not involved in the writing, approval, or decision to publish this manuscript. Footnotes Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. They have no f... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.587 | 0.854 | ["communication", "decision_making", "ethics", "war_conflict", "education"] | 512 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.691391 | [
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sibility for the integrity of the data and the accuracy of the data analysis. The corresponding author also had final responsibility for the decision to submit for publication. No medical writer or editor was involved in the creation of this manuscript. Conflict of interest statement: No conflicts of interest. None of ... | https://pmc.ncbi.nlm.nih.gov/articles/PMC5532056/ | partnering with allied health professionals to reduce diagnostic errors | pmc.ncbi.nlm.nih.gov | public_domain | false | 0.528 | 0.852 | ["leadership", "war_conflict", "decision_making", "ethics", "networking"] | 508 | Team Health Diagnosing Dysfunction | topic | 2026-04-14T23:38:28.691503 | [
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