Scheduling Sustainable Homecare with Urban Transport and Different Skilled Nurses Using an Approximate Algorithm

Round 1

Reviewer 1 Report

1. The authors state that the main point of the article is developing an algorithm, yet a more detailed explanation is needed to better understand the methodology behind its development. The article focuses on how it can be applied, however, the method behind its development is still missing.

In sustainability terms, it is important to point out that the present article is about a 402  developed algorithm which, despite its main leitmotif being to reduce HC system costs by 403  considering different transport systems, is based on the constraints imposed by patients as to 404  the times that their HC requires as the routes initially defined by the CCE are based on HC 405  and welfare criteria

2. Early in the article, the authors should compare the algorithm with existing or similar metrics. This can be done for example in the introduction section for example. A compatrative analysis across various metrics is still needed to ground the authors’ research.

3. Alongside the quantitative analysis, the article needs to be grounded with substantive literature to proof the validity of the algorithm.

Author Response

Dear Reviewer,

 

We very much appreciate all your remarks, which have helped to considerably improve the presented paper. In the paper sustainability-600542, we have included the following:

A detailed explanation of the methodology used in Developing the algorithm A comparative analysis of the developed algorithm results. The bibliography on the subject has been extended Details of aspects related to sustainability and urban mobility A graph that clearly presents the general algorithm procedure A discussion of the results, and implications to manage the proposed approach

The whole text has been revised to detect any typos.

We would be happy to provide any further information you may require, and look forward to hearing from you soon.

Thank you very much.

Yours faithfully,

 

 

Lorenzo Ros McDonnell

Reviewer 2 Report

Generally, this is an interesting work trying to improve the use efficiency of homecare service, which is meaningful and useful. By comparing with the current data provided by the CCE of the investigated city, the proposed algorithm was shown to be able to improve the homecare service use efficiency. We can say the algorithm was validated. But the author claims in the abstract that ”the algorithm was tested…, and was successfully used to”. Is this right? The algorithm was never implemented.

I would suggest to simplify the discussion from line 117 to 173. Most of the content could be moved to introduction section.

 

Author Response

Dear Reviewer,

 

We very much appreciate all your remarks, which have helped to considerably improve the presented paper. In the paper sustainability-600542, we have included the following:

The algorithm was tested in the CCE installations with very successful results compared to the previous way (first come, first served) The algorithm formed part of the research/collaboration work, and its implementation was never its objective. Tests were run using Excel tables which included all the data and the algorithm was scheduled (using macros to make it quicker), and always supervised by those in charge at the CCE service. We have modified the discussion between lines 117 and 173 by including a explanation of the approach methodology used in developing the algorithm A comparative analysis of the developed algorithm results. The bibliography on the subject has been extended A graph that clearly presents the general algorithm procedure

The whole text has been revised to detect any typos.

We would be happy to provide any further information you may require, and look forward to hearing from you soon.

Thank you very much.

Yours faithfully,

 

 

Lorenzo Ros McDonnell

Reviewer 3 Report

The paper presents a very interesting study on the assessment of home healthcare services taking into account both costs and resources consumption. With this goal in mind the Authors present an algorithm that allows an optimization of the routes and transportation means. The paper is well written and organized.

However, the manuscript presents some shortcomings that need to be addressed.

Firstly, due to the nature of the target journal (i.e. Sustainability) the background analysis should also consider aspects related to urban mobility and transportation means (e.g. you might consider the following studies: doi: 10.3390/su10020479; 10.3390/su8010029).

As far as the methodology is concerned, a flowchart representing the overall procedure could help the reader in better understanding the proposed approach (e.g. at the beginning of section 2.2).

Moreover, the computation of the efficiency (STAGE 5 of the procedure) should be better explained, providing details on the scientific foundation of the definition provided with equations (12) and (13).

In the discussion of results, the Authors should take into account also managerial implication of the proposed approach. Moreover, since in literature these types of analyses are carried out mainly using life cycle evaluation tools (e.g. by means of Life Cycle Assessment (LCA), Life Cycle Costing (LCC), Screening Life Cycle Modelling (SLCM) methods), the Authors should discuss the benefits deriving from the use of the proposed algorithm (i.e. a value based approach) in comparison to the above mentioned tools. For example, as a reference you could consider the following studies: doi:10.3390/su9030421; https://www.designsociety.org/download-publication/32055/product%e2%80%99s+life+cycle+modelling+for+eco-designing+product-service+systems; doi: 10.3390/su9060994.

Finally, at a more general level:

- the manuscript should be edited following the journal rules.

- some typos can be found in the text (e.g. Lines 250-252. A bracket is missing).

Author Response

Dear Reviewer,

 

We are most grateful for all the remarks made, which have helped to considerably improve the presented paper. In the paper sustainability-600542, we have included the following:

The urban mobility and transport means aspects have been included by incorporating the two proposed articles, among others A flow chart of the methodology has been included to represent the general process Details of Algorithm stage 5 have been included, as have the scientific bases of Equations 12 and 13 The implications of managing the proposed approach have been included in the Discussion. The two proposed articles have been considered by explaining the benefits obtained from using the present algorithm The article has been revised in order to detect any mistakes and to check that it follows the journal’s guidelines

The whole text has been revised to detect any typos.

We would be happy to provide any further information you may require, and look forward to hearing from you soon.

Thank you very much.

Yours faithfully,

 

 

Lorenzo Ros McDonnell

Round 2

Reviewer 3 Report

The manuscript has been improved in a significant manner.

However, still in the discussion of results, the Authors should better highlight methodological implication of their study. In particular, given that the proposed approach relies on the optimization of the efficiency of the logistical services provided in terms of time reduction, this reviewer thinks that the Authors need to discuss the benefits deriving from the use of the proposed algorithm (i.e. a value based approach) in comparison to the approaches based on the life-cycle assessment (where the efficiency is calculated differently). Accordingly, the three studies suggested previously (doi:10.3390/su9030421; https://www.designsociety.org/download-publication/32055/product%e2%80%99s+life+cycle+modelling+for+eco-designing+product-service+systems; doi: 10.3390/su9060994) were meant to provide the Authors with an insight/basis for a more thorough discussion of this aspect.

This could enrich the value of manuscript considering the type of audience of the journal, shedding more light on the benefits of the proposed approach.

 

 

Author Response

In this third version, we have included the remarks raised by the reviewers, all of which have been helpful. We very much appreciate the suggestions made to improve the paper, particularly for the audience it addresses. An attempt has been made to stress the benefits of the approach herein proposed as follows:
Ø We have attempted to improve and highlight the methodological implication of this study.
Ø The approach herein proposed is based on optimising the efficiency of the provided HC services in terms of reducing the total time, along with the number of female nurses required to cover the daily HC schedule. Therefore, we have expressed the benefits that arise from the proposed algorithm. The presented study is not focused from the life cycle.
Ø We have included the three studies suggested by the reviewer, which has provided us a perspective and basis to analyse the developed algorithm and allows various aspects to be included in the both the previous and current revised versions.

Nonetheless, we wish to point out that we have restricted our research to the framework of the algorithm, which intends to solve the daily scheduling of HC activities by including social aspects of the patient-nurse interaction, as well as environmental aspects of the different types of transport available and economic aspects that derive from combining the possible existing solutions.

Author Response File: Author Response.pdf

Round 3

Reviewer 3 Report

The Authors have augmented the quality of the manuscript sufficiently. Hence, in this reviewer opinion it can be considered for publication.