Review for 10.1186/s12876-021-01661-4 (2021)

Reviewer’s report
Title: 
A Patient-Centered Framework for Health Systems Engineering in
Gastroenterology: Improving Inpatient Colonoscopy Bowel Preparation
Version: 
0 
Date: 
06 Aug 2020
Reviewer's report:
I enjoyed reading this study entitled "Improving Inpatient Colonoscopy Bowel
Preparation: A Patient-Centered Framework for Health Systems Engineering in
Gastroenterology." This is a research article about the efficacy of improving
inpatient colonoscopy bowel preparation using health systems engineering
principles. The authors concluded that by addressing issues at patient, provider,
and system levels with health systems engineering principles, they could address
patient safety and quality of care provided by improving rates of adequate ICBP.
1. As results from the previous studies, it is possible to simply increase the
effectiveness of bowel preparation through changing the preparation regimen or
patient education or nurse education. It would be good to adequately explain
whether using this method is effective against time and cost in a medical
institution. 
2. In addition, it is unlikely that it is possible to apply the same aspects
applicable to tertiary medical institutions in secondary medical institutions. It
would be nice to explain about this.
3. In the method section, it would be better to explain the HSE method so that it
is easy for readers to understand and in the result section, the process of phase 1
is too complicated to understand. Briefly present what authors want to explain.
4. Low volume PEG was suggested as an effective large volume PEG method.
Give reasons why the authors used large PEGs in this study.
5. It is not appropriate to simply evaluate LOS or adequate ICBP to conduct a
quality improvement 
project. Shouldn't authors evaluate patients' satisfaction and
overall quality of life in hospitals after hospitalization and endoscopy?
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons upon publication of the manuscript. If you have already registered at
Publons, they will notify you of the receipt of this review and update your profile
as per your settings and their policy. If you are not registered with Publons, you
will receive an email from them asking you to register in order for them to be
able to recognize your review on your new profile page. Publons may use the
Review Data to generate derivative metadata for the benefit of Publons and you
as a reviewer, carefully considering the sensitivity of such information. For
example, Publons may verify your record as a reviewer by updating your profile
published on its webservice if you have registered for such service or help
editors to identify candidate reviewers. Please find the details of processing in
Publons’ privacy policy 
https://publons.com/about/terms
No
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests' below. If your reply is yes to any,
please give details below.
Reviewer Publication Consent.
 I agree for my report to be made available
under an Open Access Creative Commons CC-BY License (
http://creativecommons.org/licenses/by/4.0
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the editorial
office before completing the review.
If you wish, you can include your name in your published report. Please note
you must decide whether to include your name at the start of the process and
confirm this decision whenever prompted. If you change your decision later, we
will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please 
do not
 publish my name
with my report. (default)
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes