Identification of Predictive Nursing Workload Factors: A Six Sigma Approach
Round 1
Reviewer 1 Report
I have carefully read and critically evaluated the article entitled "Identification of predictive nursing workload factors: a Six Sigma approach".
The methodology used is very interesting and well structured.
Discussion: The following points emerge:
1) I recommend expanding the literature and improving the discussion with more arguments in order to increase the interest of readers.
2) Improve Native English
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Abstract:
Line 14: ... the number of nurses, and the number of shifts ...
Line 17: not clear what kind of target this 55% is from this Abstract.
1. Introduction:
Line 7: increments in
Need to insert commas after [3] and also after [4]
Line 31: You talk of 'several studies' here, but only offer one in-text reference ...
Line 77: which 'other authors'?
2. Research Methodology:
Line 192: insert 'respectively' after 40%
Line 193: insert 'respectively' after 48%
Line 196: two types of shifts
Line 269: a the split of day and night shifts in that sample is?
Line 275: is that also true if one separates out day and night shifts?
Line 311: insert a comma after NW - and remove the comma currently present after [39]
Line 314: we propose
Line 354: universities
5. Conclusions:
Line 377: ... the frequency of medication ...
Line 392: ... ensuring a fair use ...
References:
do NOT invert the article title, but rather the journal title or (edited) book title
Reference [3] - spell out D.o.E. and P.D. Social Affairs
Reference [4]: Journal of Medical Internet Research
Reference [5]: Human Resources for Health
Reference [6]: The Journal of Nursing Administration
Reference [10]: Applied Nursing Research
Reference [11]: Journal of Biomedical Informatics
Reference [12]: Healthcare Management Science
Reference [13]: Journal of Nursing Management
Reference [14]: Journal of Nursing Management
Reference [15]: Journal of Advanced Nursing
Reference [20]: Journal of Postgraduate Medicine
Reference [28]: Journal of Evaluation in Clinical Practice
Reference [30]: Journal of Medical Biochemistry
Reference [41]: Journal of Operations Management
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Reviewer 3 Report
Dear Authors,
The paper presents very interesting analysis of Six Sigma application as failure identification tool for predictive nursing workload. The aim was to show that Six Sigma methodology can be effectively used to estimate the importance of identified factors that could affect nursing workload in order to improve the nurse-patient assignment process. I would like to emphasize the novelty of the work by applying the generic methodology instead of using the “customer” side of view, by using survey data or similar.
Concerning the emerging need of better workload planning in healthcare centres, I would like to emphasize the need to have more analysis like presented in the paper.
The problem was clearly identified and introduced to the readers, as well as the existing challenges.
The authors have clearly stated the identified scientific gaps and the need of such analysis. The motivation is strong and well-addressed. The references are current and include the novel research published in recent years.
The Introduction should provide the structure of the paper in the end of the section. This overview would give the clear insight of the paper to the readers.
I would recommend that authors use Ishikawa diagram that is most commonly used for service-oriented processes as 4S (Suppliers, Systems, Surroundings and Skills) and to completely rewrite the section “Analyse” lines 220-227. With this 4S analysis the results would be more clear and can be applicable to other identified problems not only in healthcare but also other service industries.
The discussion section should include the novelty of such analysis. I would like that Authors use their results to point out the scientific contribution of their research.
In the conclusion, there are no strengths, nor limitation of the presented approach, in order to give more clear picture to the readers.
It would be very beneficial that authors provide a comparison discussing the results of other similar analysis.
I would like that Authors also include the future research that could extend the existing analysis presented in the paper.
Author Response
Please see the attachment
Author Response File: Author Response.pdf
Round 2
Reviewer 3 Report
Dear Authors,
The paper has been significantly improved. You have addressed and corrected all the given remarks and provided additional explanations.
