1.A Regional Integrated NST System: Interprofessional Collaboration and Establishment of the “Ibi Model”
Kazumi TUIKI ; Iwao KUMAZAWA ; Noriko KAWASE ; Hiroki YAMADA ; Fumio WATANABE ; Tomoko MABUCHI ; Mihoko TAKAI
Journal of the Japanese Association of Rural Medicine 2018;67(2):113-
Ibi Welfare Hospital covers a local town that has an aging population, and the development of a community-based integrated care system is an important issue. We have established and are operating a regional integrated NST system to maintain oral nutrition intake essential for daily life and prevention of pneumonia in this area, and here we report on outcomes and future issues. In this study, we investigated the regional integrated NST system (NST outpatient · NST hospitalization · NST visit) and examined dissemination of its service. Data was collected from February 2016 to March 2017. The investigation involved the following: (1) extraction of survey results of latent NST subjects and retrospective investigation of medical records; (2) expansion of NST outpatient services (examinations by surgeons, endoscopic evaluation of swallowing function, blood tests, dental examination, and evaluation by a dietician speech-language-hearing therapist, and return of a joint report created by the individual professionals to the introducing professional); and (3) introduction of NST hospitalization (2-week hospital stay for local inclusion sickbed care, introduction of swallowing passport, initiation of rehabilitation, oral care roundtrip, NST roundtrip, personnel care meetings with home staff, and introduction of visiting speechlanguage-hearing therapist rehabilitation to support home care after discharge). To increase awareness of this system, we visited the local nursing care insurance agency and welfare hospitals and tried to obtain cooperation through transparency. Introducing and initiating this regional integrated NST system “Ibi Model” revealed that the system is greatly needed in our region. We think that it has the potential to become a key supporting tool for the home-based medical care system within the regional comprehensive care system. Further verification is needed to assess real outcome changes such as a decrease in the incidence of pneumonia and improvement in quality of life.