Present status and future prospects of nutritional support teams

Academic interest in nutritional support teams (NSTs) has increased rapidly in Japan since 1999, when they were first planned by the Japanese Society for Parenteral and Enteral Nutrition (JSPEN). The JSPEN promoted their use extensively after 2006 when extra medical fees were approved for medical management by NSTs under the national health insurance system. The purpose of NSTs is to provide the best nutritional support to patients who are malnourished or at high risk of developing malnutrition, without causing conflict among different medical staff. NSTs offer appropriate medical support and help prevent the deterioration of patients' health. The teams are comprised of specialized medical staff with nutritional expertise who work at the bedside and are committed to establishing good medical practice. The main targets of NSTs are patients who undergo surgery or are being treated in a geriatric or internal medicine unit, including those with lifestyle-related diseases. Therefore, most targets of NSTs are patients with common conditions. A package medical system based on the diagnostic-procedure combination was established, and regional medical centers were integrated to ensure high-quality medical care throughout Japan. Under this system, NSTs are expected to resolve individual patients' dietary issues. In addition, improvement of medical care quality and the training of reliable medical staff are necessary to provide nutritional management in the clinical setting. It will be necessary to the revise the assessment of NSTs as proposed by a committee of the Japanese Nutritional Support Promotion Group or to carry out surveillance to evaluate the outcomes of NST activity.