Objective: Our facility distributes postcard-format questionnaires to persons undergoing full medical examinations. The questionnaire content evaluates the staff response, environment and equipment, health check-up content, wait times, and desire to repeat the experience. Between 2014 and 2017, data from 4,941 questionnaire postcards were collected to investigate the correlation between “desire to repeat the experience” and each questionnaire item.

Methods: Responses for “staff response,” “environment and equipment,” “health check-up content,” and “wait times” were evaluated on a 5-level scale, while that of “desire to repeat the experience” was evaluated on a 4-level scale. Data analyzed were from 4,841 questionnaire postcards collected between 2014 and 2017; postcards with any omitted responses were excluded. The survey used Spearman’s rank correlation coefficient (r_s) to identify items strongly associated with “desire to repeat the experience.”

Results: “Staff response” in 2017 had the highest value of r_s at 0.69, followed by “environment and equipment” in both 2014 and 2017 at 0.67. Furthermore, “wait times” had the lowest r_s value at 0.58 in 2015; however, from 2014 to 2017, all questionnaire items and “desire to repeat the experience” showed correlation coefficients between 0.58 and 0.69, indicating a strong correlation.

Conclusion: Results of the survey conducted at our facility identified a strong correlation of “environment and equipment” and “staff response” with “desire to repeat the experience.” However, since these values could also suggest strong correlations with other items, heightened evaluation of all survey items may increase the positive evaluations, indicating increased “desire to repeat the experience.”

Objective: Due to an increase in the number of examinees, complaints about long waiting times and not completing all health check-ups in the morning have increased.

This study aimed to determine whether we could reduce the waiting time for examination and improve the comfort of examinees by changing the order of abdominal ultrasonography in a series of examination.

Methods: We handed out questionnaires to our staff to determine which examination resulted in longer waiting times. Based on the results, the order of examinations was changed, and the distribution of waiting times for abdominal ultrasonography was compared every 10 minutes.

Results: According to the questionnaire, procedures that resulted in long waiting time were physical check-up by a doctor, abdominal ultrasonography, and confirmation of the contents of a questionnaire by a nurse, in this order. Based on the results, the order of the examinations was changed to complete abdominal ultrasonography earlier. Before the change of order, the percentage of patients with an abdominal ultrasonography waiting time of less than 10 minutes was only 51.0%. However, after changing the order, no examinee had to wait for more than 40 minutes. In addition, comparing the end times of abdominal ultrasonography.

Conclusions: By changing the order of examination, the waiting time for abdominal ultrasonography can be shortened, and the length of the series of examinations can also be shortened, possibly leading lead to preferable results on the acceptance of more examinees to Ningen Dock in the future.

Objective: Beginning in 2018, Japan’s system of ＂specific health check-ups＂ and ＂specific health guidance programs＂ (to screen for and control metabolic syndrome and other lifestyle diseases) entered its third phase with the adoption of a flexible model for running the intensive version of the specific health guidance program. This study aimed to test if there may be an effective lower limit threshold of the current 180-point health guidance system, given that the new model for the program uses the Niigata method.

Methods: The sample consisted of 202 participants who underwent a specific health check-up between April and December 2018 and then participated in the intensive assistance (sekkyokuteki shien) version of the specific health guidance program. The participants were divided into four groups according to the guidance program’s point system, which indicates the number of support types offered in the program the person had used (Group A: 0 points, Group B: 20 points, Group C: 100 points, and Group D: 180 points). We conducted a performance evaluation three months after the program ended. The participants were classified as ＂achievers＂ if they made significant progress: if their waist circumference had decreased by at least 2.0 cm and their weight had decreased by at least 2.0kg. The prevalence of achievers in each group was compared to investigate whether there was an effective lower limit threshold. In addition, the following year, the participants’ special health check-up results were compared to confirm whether the effectiveness of the program was sustainable.

Results: The achiever prevalence rates by group were 20.4% for Group A, 36.0% for Group B, 28.0% for Group C, and 12.5% for Group D. Only Groups B and D showed any significant between-group differences. The following year, the percentages of achievers in each group who sustained their achiever performance status were 80.0% in Group A, 88.9% in Group B, 92.3% in Group C, and 100% in Group D. No significant differences were found between groups.

Conclusion: Our results showed no relation between the number of points and the effect of the health guidance program, and no effective lower limit threshold. In addition, the effectiveness of the program was shown to be sustainable.

Objective: Response rate (RR) is one of the key performance indicators of operational efficiency. As the number of medical examinees increases, it becomes difficult to make a reservation by phone smoothly because of an increase in number of abandoned calls at our medical check-up. To enhance customer satisfaction (CS), we aimed to reach a 90% RR by starting a call center and using an interactive voice reaction (IVR) system. Here, we report the findings.

Methods: In 2012, a call system to calculate RR and a work force management (WFM) system to arrange human resources were introduced. In addition, we established a call center, and provided guidelines for the reservation service and a script for operators to be able to provide a unified response for customers. In 2014, we upgraded the reservation system, allowing customers to make reservations not only by phone and post, but also by fax. In 2017, an IVR system was introduced to reduce customer inquiries. CS was evaluated using questionnaire surveys in 2011 and 2020.

Results: RR increased from 46.5% to 64.6% after the establishment of the call center. Furthermore, RR reached 72.0% after the introduction of the fax reservation system, and further increased to 98.5% after the IVR system was introduced. The result of the questionnaire survey showed a decrease in customer dissatisfaction with phone connectivity in 2020 compared to 2011.

Conclusions: Our initiatives, including establishing a call center and using IVR, realized over a 90% RR. As the RR improved, CS also increased.

Objective: We evaluated qualitative coronary artery calcification (CAC) by visual assessment and the significance of risk factors in human dock lung cancer CT screening.

Methods: The subjects consisted of 184 people who underwent lung cancer CT screening from April 2019 to March 2020 (average age 60±9 years, male 172, female 12). A visual qualitative evaluation of CAC was performed in chest CT cases for a lung cancer work-up. Chest CT was performed with a 16-row multi-slice CT (HITACHI, Supria^®), with non-gated non-contrast acquisitions, and 5-mm slice thickness. Those in which there were two or more slices of calcification in the main coronary artery region were classified as being ＂moderately positive＂ We examined the presence or absence of CAC, health check-up items, and Framingham score.

Results: In 184 cases, there were 30 cases (16.3%) with moderately positive CAC. The mean age was 65.7±5.3 (range, 55–77 years), and the frequency was higher in men (90%). Logistic regression analysis of health check-up items related to CAC with 78 cases with age-matched no calcification group showed Age (≥70), BMI (≥25), diabetes, LDL cholesterol (≥180 mg/dL), and 12-lead ECG abnormality. The Framingham score was significantly higher in the CAC group (10.0±4.2 vs. 6.9±2.9, p<0.01).

Conclusion: CAC by visual qualification on lung cancer CT screening with non-gated and non-contrast acquisitions was associated with lifestyle-related diseases and was a useful method of assessing the risk of coronary artery disease in human docks.

Objective: We aimed to improve the visualizing ability of pancreatic ultrasonography images by re-examining the pancreas.

Materials and Methods: This study included 14,096 people who underwent health check-ups in our clinic between November 2017 and October 2018. In November 2017, to improve and uniformly visualize pancreatic sonographic images, we changed some naming of the findings and created our own technical manual. After the routine examination, a notification was sent to the examinee who had shown non-detected parts in the pancreas, indicating the necessity of re-examination. Abdominal ultrasonography (US) was performed in response to the application of the patient. If the re-examination failed to depict the non-detected parts, the “liquid filled stomach method” was combined with beverage-in-take. The images were first scored at the time of routine examination, second at the time of re-examination, and third after beverage-ingestion, and a comparative study was conducted among the scores in consideration of each BMI.

Results: Of the 429 patients with non-detected parts, only 40 applied for the re-examination. Of the 40 patients, 12 had high obesity, with a BMI of 37.0, which achieved full-marked good images without beverage-intake. The liquid-filled stomach method was combined with beverage-intake in the remaining 28 patients with non-detected parts at the time of re-examination, and image improvements were observed in all 16 patients including those with high-grade obesity (BMI 45.0), showing higher scores after beverage-intake.

Conclusion: The re-examination of the pancreas with non-detected parts at the routine US showed a remarkable improvement in combination with the “liquid filled stomach method,” strongly suggesting a possibility of its decreasing effect on invasive diagnostic methods such as contrast enhanced CT. Further studies should be conducted to refine the diagnostic process of the pancreas.

Objective: People of age 40 years or above with metabolic syndrome (MetS) are said to have triggered the condition by inappropriate lifestyle habits before the age of 40, and it is necessary to improve these habits from this time. Therefore, among male patients under 40 years, we examined the present state of a MetS group, a MetS preliminary group (preliminary group), and a non-metabolic high-risk group (high-risk group) who showed abnormal test values with normal abdominal circumferences.

Methods: Among men below 40 years of age in whom MetS could be judged in fiscal 2017, 2,527 patients were classified into a MetS group, preliminary group, high-risk group, and a healthy group. Body shape, clinical laboratory values and lifestyle habits were examined.

Results: There were 151 cases (6.0%) in the MetS group, 408 cases (16.1%) in the preliminary group, and 43 cases (1.7%) in the high-risk group. In the MetS group and the preliminary group, there was ＂weight gain of 10kg or more from the age of 20＂, and ＂speed of meal intake＂ was fast. The ＂daily＂ rate of alcohol consumption was higher in the high-risk group, and the volume of drinking was higher in each group than in the healthy group. In addition, those who are exercising in the healthy group were not necessarily more frequent. For smoking and eating habits, there was no significant difference in each group, and many individuals were considered to lead inappropriate lifestyle habits even among those in the healthy group.

Conclusion: In the MetS group and the preliminary group, there were many individuals who gained weight; thus, it is necessary to first avoid becoming obese. On the other hand, there was a large proportion of individuals in the healthy group who lived inappropriate lifestyles; therefore, it is necessary to improve lifestyle habits regardless of their current health state.

Objective: To survey the true prevalence of locomotive syndrome (Locomo) among the staff working in a hospital in order to consider counterplans for its prevention.

Methods: The levels of Locomo among the staff of an acute care hospital were examined by conducting Locomo tests (testing the ability to stand, two-step test, and administration of the Locomo 25 questionnaire) in 239 staff members in their 20s to 50s (average age, 39.20 ± 10.31 years; 63 men and 176 women). The results were analyzed by age and occupation, and statistical analysis was performed using SPSS.

Results: The Locomo test revealed that 62 staff members (25.9%) had Locomo. The percentage of individuals in their 50s with Locomo increased by approximately three times that of those in their 40s. When analyzed by applicable items, the percentages of Locomo 25 alone and both motor function and Locomo 25 increased in nurses in their 50s, while the doctors, office workers, and technical staff showed a significant increase in the proportion of decreased motor functions alone in their 50s in comparison with that in their 40s or younger. The results of the Japan Low Back Pain Evaluation Questionnaire suggested that low back pain was related to Locomo in nurses in whom the proportion of women was significantly higher than that in other occupations.

Conclusions: In this study, the rates of Locomo by age group were different from those reported previously, possibly due to the differences in occupation and sex analyzed. For nurses, as back pain may have been a factor causing Locomo in their 50s, measures of back pain are important for the prevention of Locomo.