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Nutrition support teams: Institution, evolution, and innovation.

Albert Barrocas1, Denise Baird Schwartz2, Bruce R Bistrian3

  • 1Department of Surgery, Tulane University School of Medicine, Atlanta, Georgia, USA.

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
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PubMed
Summary

Nutrition support teams (NSTs) evolved over 60 years from multidisciplinary to transdisciplinary models. Innovations focus on patient-centered care, ensuring optimal nutrition delivery.

Keywords:
enteral nutritioninterdisciplinarynutrition supportparenteral nutritionpatient care teamtransdisciplinary

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Area of Science:

  • Clinical Nutrition
  • Healthcare Management
  • Team Science

Background:

  • Nutrition support teams (NSTs) originated to manage parenteral nutrition safely.
  • Early NSTs utilized a multidisciplinary approach, formalized by the American Society for Parenteral and Enteral Nutrition (ASPEN) in 1976.
  • Healthcare policy changes, like the 1983 inpatient prospective payment system, impacted NST funding and function.

Purpose of the Study:

  • To present the historical evolution and innovations of nutrition support teams (NSTs).
  • To discuss the transition towards transdisciplinary and patient-centered care models.
  • To explore future directions for NSTs in optimizing nutrition support.

Main Methods:

  • Historical review and analysis of the development of nutrition support teams.
  • Examination of the shift from multidisciplinary to transdisciplinary practice.
  • Discussion of factors influencing NST membership, leadership, and integration into healthcare systems.

Main Results:

  • NSTs have evolved significantly over six decades, adapting to healthcare changes.
  • The concept of transdisciplinarity, emphasizing function over discipline, is increasingly adopted.
  • Adaptations include "top-of-license" practice and integration of nutrition support into broader healthcare teams.

Conclusions:

  • NSTs have transformed from a multidisciplinary to a more flexible, transdisciplinary model.
  • Future innovations aim to personalize nutrition support for each patient.
  • Nutrition care is recognized as a fundamental human right, guiding future NST development.