Evaluation of the Usage Requirements of Hospital Signage Systems Based on the Kano Model
Round 1
Reviewer 1 Report
Recently, the topic of the paper has been popular and interesting. The paper is well prepared; its arrangement is logical. The writing style is used at a good level.
The methodology is proper and clear, and it is comprehensibly formulated and explained.
There are some new, well-invented ideas presented. However, authors indicated in the abstract that the results will provide design suggestions and guidelines for the improvement of the hospital signage systems. The section “Results” is full of comprehensibly inscribed results of the Kano model questionnaire, and recommendations for the quality of the signage system in understudy hospitals are only weakly included in the Discussion. Based on the abstract and last sentence of the Introduction (lines 125-126) I expected that the recommendations proposed by the authors would be systematized or at least more systematically commented on in the results of the paper or in the discussion.
The text that follows the table 6 (lines 315 - 338) is useless or unnecessarily long. It does not bring any new information. It only repeats what is clear in Table 6 and can be read in it.
A large number of cited documents (References) are old.
Formal comments:
Lines 120-123 – two hospitals are mentioned; probably three hospitals were under study (line 209 and line 437)
The sentence “Kano Quality Type The evaluation table is shown in Table 1.” (lines 194-195) seems to be somewhat strange.
Author Response
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Author Response.pdf
Reviewer 2 Report
Recommendations for changes
- Authors should analyze the relevance of inverting the quadrants of the graph shown in Figure 2. Traditionally, the upper left quadrant refers to “Attractive quality (A)” while the lower right quadrant refers to “Must-be quality (M)”. Moreover, traditionally, the horizontal axis refers to “Worse (Worse/DSI indicator)” while the vertical axis refers to “Better (Better/SI indicator)”. Authors must maintain the configuration suggested by the creator of the method in their original work;
- It is recommended to standardize the graph scales in Figure 2 (0.0 to 1.0 on both axes), so that the quadrants have the same area.
- Check and correct the wording of the text between lines 321 and 353, as there are duplicate requirements.
Author Response
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Author Response File: Author Response.pdf
Reviewer 3 Report
The topic is interesting and relevant but the article need major review
- in the abstract the study aim is declared to identify the TYPEs and IMPORTANCE of hospital signage systems. This aim should be highlighted in a clear way in the conclusion to verify if it is reached or not.
- design suggestions and guidelines are not provided. Additionally a paper cannot provide guidelines which are a target of Ministery activities or dedicated institutional bodies
- lines 23-24 report a global issue, not only for China
- lines 28-29 represent a hard statement, is is referenced in studies or is just a feeling of the authors?
- jargon is often used i.e. lines 30, 454, 208. Please use adeguate language and sentence structure for a scientific paper
-the research gap and objective should be clarified at the end of Introduction section
- Is the KANO model a framework (line 143) or a classification model (line 170) or a theory(line 497)?
- the authors could benefit from understanding the link between QUALITY and SUSTAINABILITY in Hospital facilities for example looking at:
Elf, M., Nordin, S., Wijk, H., & Mckee, K. J. (2017). A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare. Journal of Advanced Nursing, 73(12), 2796–2816. https://doi.org/10.1111/jan.13281
Brambilla, A., Lindahl, G., Dell’Ovo, M., & Capolongo, S. (2020). Validation of a multiple criteria tool for healthcare facilities quality evaluation. Facilities, in press. https://doi.org/10.1108/F-06-2020-0070
Anåker, A., Heylighen, A., Nordin, S., & Elf, M. (2017). Design Quality in the Context of Healthcare Environments: A Scoping Review. HERD: Health Environments Research & Design Journal, 10(4), 136–150. https://doi.org/10.1177/1937586716679404
Melo, S. (2018). The role of place on healthcare quality improvement: A qualitative case study of a teaching hospital. Social Science & Medicine, 202, 136–142. https://doi.org/10.1016/j.socscimed.2018.03.003
Mikulić, J., & Prebežac, D. (2011). A critical review of techniques for classifying quality attributes in the Kano model. Managing Service Quality: An International Journal, 21(1), 46–66. https://doi.org/10.1108/09604521111100243
- it is not clear where the categories used in lines 210-211 are coming from
- is the scale of measurement a LIKERT scale?
- the discussion section must be restructured. It should position the findings against the existing body of knowledge. For example there are several studies about the way finding system that must be taken into account i.e. Pati, D., Harvey, T. E., Willis, D. A., & Pati, S. (2015). Identifying elements of the health care environment that contribute to wayfinding. HERD, 8(3), 44–67. https://doi.org/10.1177/1937586714568864
Author Response
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Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
The authors made the proposed changes. They also updated the bibliographies, in addition to improving discussions of results and conclusions. However, it is necessary to make some amendments, unfortunately not observed in the first evaluation:
1) Reclassify function D2 (fun and stylish) in Table 6 to [One-dimensional quality (O)] (coordinates 0.51; 0.51). Verify that in Figure 2, the D2 function is in the upper left quadrant [One-dimensional quality (O)] and in Table 6 and in the text the authors considered it in the lower left quadrant [The must-be quality (M)]. Consequently, it is necessary to amend the text (for example, see lines 378, 435, 429, 451, 490, 513, 520).
2) Verify in other parts of the text the necessity for adaptations due to the alteration indicated in item 1, mainly in the items “Results” and “Discussion”.
3) In Table 7 the function “C2” is duplicated in the item “Use level”.
4) Due to the reclassification of the “D2” function, the “Demand Importance Ranking” column must be changed, specifically for the lines “Attractive Level”, “Must-be (M)” and “One-Dimensional (O)”. The new sequence for the “Attractive Level” line should be: D1>D2>D4>D3>D5. The new sequence for the “Must-be (M)” line should be: B1>B4>A1>A7. The new sequence for the “One-Dimensional (O)” line should be: A8>D1>C6>D2.
Author Response
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Reviewer 3 Report
the revised version improved the overall quality of the paper
Author Response
Thank you very much for carefully checking the revised manuscript and your valuable comments. Those comments are very helpful for improving our paper. We used the "Track Changes" function to edit and highlight the manuscript. The minor revisions are marked in blue and purple in the manuscript for convenience. We hope the revised manuscript can meet the publication requirements.
