Peer Review History
Original SubmissionJuly 10, 2019 |
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PONE-D-19-19443 Exploring the hospital patient journey: how can we capture the patient’s experience? PLOS ONE Dear Dr. Gualandi , Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== Please address reviewer comments as well as the following: Literature review - further detail on the theoretical basis of shadowing and rationale for it's use. Methods Data collection - was there any prior relationship between the researcher and potential participants? How were issues of possible coercion dealt with? Please provide further information on shadowing and how the field notes were dealt with Much greater detail is required in reference to Plutchik's Wheel of Emotions and the rationale for its use as a framework in this study. Line 146 include "with participant permission" Results Please include some minimal demographic characteristics of participants. Please provide a better link between the text and Table 2 The data presented seems to come from the interviews - where is the data from the shadowing included? ============================== We would appreciate receiving your revised manuscript by 30 September 2019. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript:
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Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 3. Please consider including more information on the number of interviewers, their training and characteristics. 4. Thank you for stating the following financial disclosure: NO - The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript a) Please provide an amended Funding Statement that declares *all* the funding or sources of support received during this specific study (whether external or internal to your organization) as detailed online in our guide for authors at http://journals.plos.org/plosone/s/submit-now. b) Please state what role the funders took in the study. If any authors received a salary from any of your funders, please state which authors and which funder. If the funders had no role, please state: "The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript." Please include your amended statements within your cover letter; we will change the online submission form on your behalf. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Yes ********** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: Yes ********** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: No ********** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: No Reviewer #2: Yes ********** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Title: Exploring the hospital patient journal: how can we capture the patient’s experience? Manuscript number: PONE D 19 19443 General comments Your title is Exploring the patient journey: how can we capture the patient experience? And the research questions are Which aspects of hospital patient journey experience may be captured by 3 different standpoints – shadowing, professional and patient interviews. What does the patient experience through the hospital journey and how can it be captured? The complexity and number of steps in the patient journey decoded by your research is very interesting as were other findings of patient journey. I commend you for using an ethnographic approach to try to capture the lived experiences of the patients your followed. These tools captured patient journey, the physical aspects of movement through a hospital experience; however, I am interested to know other aspects of patient experience. For example, did the hospital context/system facilitate patient understanding of their own condition and care (health literacy)? Could that be a lens you view the data gleaned from shadowing? Shadowing as a research methodology also requires more analysis in the paper. I don’t get a sense of the ‘rich’ description that the ethnographic shadowing approach should generate. It would be good to see what else that data revealed beside the annotation of components of the hospital journey, given you were trying to capture the broader experience of patients – viz Line 328 - patient mainly feels and remembers, while shadowing highlights what the patient experiences in the different contexts and going through one service and on to another, which professionals do not see since this falls outside the scope of their direct responsibility. See also Gill, R. (2011). The shadow in organizational ethnography: moving beyond shadowing to spect -acting. Qualitative Research in Organizations and Management: An International Journal, 6(2), 115-133 Line 15 – delete “the’ – definite article. Line 26 – “professionals” – a possessive? Line 32 – comma after process Line 43 – vague reference to “some others” Line 87 – reference for phenomenological-hermeneutic approach Line 90 – unless that is the name of the hospital, only ‘Italian’ should have capitalisation; however, your use of the indefinite article makes me think it is not a proper noun. Use of appendix – perhaps not needed – the table could be condensed and summarised inside a table in the text or using words. Lines 119-122 This is unclear - we need some researcher reflexivity here – what were the researchers’ roles in the delivery of patient care? Line 136 – patient’s journey/experience or patients’ journeys/experiences? Line 140 – can you explain more about sampling decisions for professional staff, esp the nurses Line 157 – Plutchik’s Wheels of Emotion needs some backgrounding – why is that appropriate and how did it fit with your phenomenological-hermeneutic approach and your research question? Table 2 reveals that patient emotions were captured, but was there any particular part of the 3 different standpoints which captured emotion? Line 180 – rules of long quotes – over 40 words – indented? Italics? Line 195 - “they began to experience a lack of autonomy and this could make them nervous (N2)” – Could you clarify what the coding stands for in your results? E.g. N or P or H? Also does one reference (N2) here mean only one person had this experience? Line 210 – verb aspect – going/gone – delete ‘having’ Lines 233 on – was this data gained from the interviews or shadowing? ? hegemonic/power relationships in that context? Any critical analysis? Line 227 – The relationship between Table 2 and patient-professional relationships could be clarified further. Line 373/4 – where was the review of the shadowing methodology challenges? Reviewer #2: Overall this is an interesting, well written study. The topic of the patient experience is important and new ways of capturing it, and using this information to improve patient care, are central to modern healthcare. Specific points follow. Page 2, line 15: “hospital patient journey experience” is an ugly noun cluster, please unpack – “the experience of the hospital patient journey”? Page 4, line 64 and in discussion: you talk a lot about different data collection methods and perspectives on the patient experience and mention a number of them – three complementary forms of which your study covers. However, one rather obvious method and perspective that you fail to mention is a hospital-stay diary completed by the patient themselves. This should at least be mentioned in discussion as another such method. A recent good example of this method is: Webster CS, Jowsey T, Lu LM, et al. Capturing the experience of the hospital-stay journey from admission to discharge using diaries completed by patients in their own words: a qualitative study. BMJ Open 2019;9:e027258. doi:10.1136/bmjopen-2018-027258 Page 4, line 70: “what he/she experiences IN real-time…” Page 4, line 72: “accurate and real data on the experience” – what does “real data” mean in this context? Who’s definition of real are you using? Better to use a different word here I think. Page 5, line 92: Line starting “Scheduled surgical patients were…” – this sentence doesn’t make much sense to me. Page 6, line 108: Sentence starting “Inclusion criteria were scheduled…” – this sentence doesn’t make much sense either. I am unsure how inclusion criteria get scheduled or performed? Do you mean the inclusion criteria were that patients must be scheduled for their procedure for the shadowing phase and must have had the procedure performed for the interviews? Page 6, line 113: “consent to participation in the study” – should be consent to participate… Page 7, line 137: “Professionals ranged…” Please make it clear that you are talking about healthcare professionals throughout – there are other kinds of professionals. Page 8, line 154: In my understanding content analysis and thematic analysis are not the same things – yet here you appear to suggest that they are? It looks more to me that you did a thematic analysis. Page 8, line 160 (table 1): I am unconvinced that the unit of meaning is a good one to support the significance of the text, or the theme. “I didn’t understand anything”, to me does not demonstrate calming of the patient, or covering professional relationships – I am sure the patient would be much calmer if they did understand what was going on, and this is the anaesthetist’s professional obligation. Page 9, line 173: “each actor allowed…” who is the actor here? The patients, clinician or researcher? Page 9, line 186 and elsewhere: I can guess that P1 means patient one (but please define), but what does PJ1, H1 etc mean? Please define on first use of each numbering scheme. Page 10, line 219: If patients ask the same questions over and over why does the hospital not supply them with a simple written information pack with frequently asked questions (FAQs)? Page 12, table 2: What is the significance of the filled dots vs the unfilled dots? Please explain or make consistent. Page 13, 241: we see the same quote as from Table 1 in the text here, why? Why not use another? Also it also seems odd to me that the anaesthetist would not address the patient by her name, rather than calling her “lady”, which actually seems rather rude. Page 15, line 277: “simple ordinary surgical pathway…” Ordinary in this context sounds strange, do you mean routine? Page 15, line 296: “had not been passed on.” – or recorded in the notes? Page 17, line 324: “…perceptions and effectiveness of the information” – surely it is more about the patient’s ability to absorb the information in a stressful situation rather than the effectiveness of the information itself? Page 18, line 359: “does not allow any generalization of results” – I would say that generalisation maybe limited rather than entirely ruled out. For example, your findings are substantially similar to those in the BMJ Open paper I mentioned previously using the patient diary method. END ********** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. 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Revision 1 |
Exploring the hospital patient journey: what does the patient experience? PONE-D-19-19443R1 Dear Dr. Gualandi, We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements. Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication. Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. With kind regards, Rosemary Frey Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ********** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ********** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: Yes ********** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ********** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ********** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: 1. Check for use of Tab instead of Table (see Lines 197 & 281) 2. Sentence (Line 397) doesn’t makes sense to me. Perhaps “In contrast to Gill (I’m still not sure though what the contrast is.) Unlike what was pointed out by Gill [44], when dealing with the 397 patient journey perspective, 398 shadowing has an important potential for revealing invisible steps and spaces of the journey, more 399 than intimate spaces and micro-processes of the decision. Reviewer #2: This is an excellent paper, and the authors have carefully addressed my review points. My only very small remaining suggestion would be to use the Italian "signora" instead of "my dear" - the English translation doesn't really capture the original meaning, and signora is a well known term in English which seems more appropriate in the context of the quote. ********** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No |
Formally Accepted |
PONE-D-19-19443R1 Exploring the hospital patient journey: what does the patient experience? Dear Dr. Gualandi: I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. For any other questions or concerns, please email plosone@plos.org. Thank you for submitting your work to PLOS ONE. With kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Rosemary Frey Academic Editor PLOS ONE |
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