Integration of a Balanced Scorecard, DEMATEL, and ANP for Measuring the Performance of a Sustainable Healthcare Supply Chain
Round 1
Reviewer 1 Report
Please find attached the Review Report.
Comments for author File: 
Comments.pdf
Author Response
Response to Reviewer 1 Comments
Point 1: The introductory section should reveal the objective of the paper. As well, the novelty and originality, alongside the contribution to the related literature is more than required. Besides, the contribution of the paper to the related literature is necessary
Response 1: Please provide your response for Point 1. (in red)
(77 – 80)
The objective of this paper is to propose a SHSCPM by combining the balanced scorecard (BSC) with the decision-making trial and evaluation laboratory (DEMATEL) and the analytical network process (ANP) with simultaneously consider to the intangibility characteristics and sustainability aspects.
(86 – 89)
Integration of the BSC with DEMATEL and ANP for SHSCPM can improve previous SHSCPM model which SHSCPM has designed by integration BSC and DEMATEL. The novelty of this paper is to add the ANP method into the SHSCPM model with BSC and DEMATEL which the model must simultaneously consider to the intangibility characteristics and sustainability aspects. The output ANP is the weight of the performance indicators based on BSC strategy map, which is then processed to determine the weight of the performance perspectives and sustainability aspects.
(80 – 85)
Originality of this paper is design a SHSCPM by combining BSC with DEMATEL and ANP. The BSC will be combined with DEMATEL to design of strategy map that represents the relationships between perspectives and indicators. The relationships are designed based on level of importance and influence by DEMATEL. Finally, the BSC strategy map will be used as input in the design of ANP structure model. The ANP structure model can be determine the weight of the performance indicators, performance perspectives and sustainability aspects.
(145 – 146)
Contribution of the paper to the related literature can enrich the SHSCPM literature based on BSC
(114 – 117)
Integration of the BSC with other methods for service supply chain performance measurement has been reported, examples: BSC and AHP – PGP (pre-emptive goal programming), BSC and game theory, BSC and fuzzy ANP, BSC and data envelopment analysis (DEA), BSC and DEMATEL. Based on this, the design of the SHSCPM can integrate the BSC with another method.
Point 2: The author(s) should argue the strengths and weaknesses as regards combining a balanced scorecard with DEMATEL and ANP
Response 2: Please provide your response for Point 2. (in red)
(347 – 350)
Strenghts : Integration of BSC with DEMATEL and ANP is new model for measuring performance of sustainable SHSC. This model more comprehensive with other models because all of supply chain actors involved to determine of performance indicators, strategy map and weight of performance indicators.
(385 – 394)
Weaknesess : First, the survey method with in-depth interviews was used with just seven expert respondents. So, the study could be improved by using more expert respondents. Second, the current study covered only East Java Province, so the findings cannot be generalized to other provinces in Indonesia. Furthermore, the SHSCPM system needs a new design with a simulation of system dynamics for predicting SHSC performance in the future based on the strategy map, weights of performance indicators and performance values in the past.
Point 3: The manuscript should comprise a distinct section towards literature review. Therewith, I recommend the author(s) to discuss the outcomes of previous studies
Response 3: Please provide your response for Point 1. (in red)
(127 – 129)
Outcomes of integration of the BSC and DEMATEL for SHSCPM on previous studies:
Integration of the BSC and DEMATEL for SHSCPM has been published, which the SHSCPM orientation has similarities with the perspectives used in services sector performance: finance, customers, operational, information and innovation & growth
Point 4: The section concerning research methodology should be further developed. In this regard, more details are essential (e.g. explanations towards the normalization matrix and total relationship matrix, the way the level of importance was computed, in what manner the significance matrix was shaped)
Response 4: Please provide your response for Point 1. (in red)
(206 – 233)
DEMATEL used for design of strategy map. Survey result were processed to the DEMATEL steps (Chen et al. 2011). Survey to identify level of influence between perspectives and indicators with 0 – 4 scale (0 = no influence, 1 = low, 2 = normal, 3 = strong, 4 = very strong). Then, strategy map is input to design of ANP structural model. Survey results were processed to the ANP (Bhattacharya et al. 2014). Survey used to pair-wise comparisons between perspectives and indicators on with scale of 1–9. Stages of the methodology:
1 Building direct relation matrix (A) based on average of influence value from ai to aj.
2 Building normalization matrix (X)
X = A x s
3 Building total relationship matrix (T),
; I as identity matrix. Calculating of importance level and influence level of perspective and indicator.
Element of T = ; where, i = rows and j = column
D and R represent direct and indirect relationships from row and column.
Where, (D + R) indicates of importance level and (D – R) indicates of influence level.
4 Building significant matrix to describe relationship between perspective and indicator. Steps to prepare for significant matrix:
- Calculation of average of T :
; Where, i = sum of row and j = sum of column
- Reduction of all T with or (T - ), value of significant matrix indicate level of relationship
5 The significant matrix describe of relationship between perspectives and indicators. Relationship between perspectives and indicators are made into a BSC strategy map which used for ANP structure model.
Point 5: The discussion of the results should be more oriented towards the social implication, rather than the technical aspects
Response 5: Please provide your response for Point 1. (in red)
(377 – 382)
Implementation of SHSCPM by integration of BSC with DEMATEL and ANP may help the management of the healthcare business to give more attention to human resources as one of intangible characteristics of healthcare business, especially for innovation and organization behaviour because most influence to other indicators. Besides that, the management of the healthcare business must be maintain customer satisfaction, patient loyalty, collaboration with supplier and stakeholder satisfaction as parts of social aspect for performance increasing.
Point 6: The final section should reveal the policy implications of the proposed SHSCPM model
Response 6: Please provide your response for Point 1. (in red)
(347 – 350)
Integration of BSC with DEMATEL and ANP is new model for measuring performance of sustainable SHSC. This model more comprehensive with other models because all of supply chain actors involved to determine of performance indicators, strategy map and weight of performance indicators.
(382 – 384)
The SHSCPM model by combining BSC with DEMATEL and ANP can help management (top and/or middle) in the healthcare business to manage the company performance with simultaneously attention to intangible and sustainability aspects.
Author Response File: 
Author Response.docx
Reviewer 2 Report
The manuscript entitled “Integration of balanced scorecard, DEMATEL and ANP for measuring performance of sustainable healthcare supply chain” is quite interesting and informative to most readers of this field. The manuscript has included interesting ideas and concepts; it is well grounded in the body of knowledge in the area. The approach followed looks useful, however the following suggestions could improve your paper.
· The main contribution of this paper should be compared with other similar studies.
· What are the main limitations of this approach?
· How decision or policy makers can benefit from this work.
· The managerial implications from this research deserves much more in-depth discussion.
· As usual a final thorough proof-reading is recommended.
Author Response
Response to Reviewer 2 Comments
Point 1: The main contribution of this paper should be compared with other similar studies
Response 1: Please provide your response for Point 1. (in red)
(145 – 146)
Integration BSC with DEMATEL and ANP can give contribution for literature enrichment of the SHSCPM literature based on balance scorecard (BSC).
(176 – 179)
SHSCPM model by combining BSC with DEMATEL and ANP can help top management and/or middle management in the healthcare business to manage the company performance with simultaneously attention to intangibility characteristic (human resources and information) and sustainability aspects. Besides, the model more effective because based on relationships between perspective and indicator that represented by strategy map and weight of indicators derived from strategy map.
As know, integration BSC and DEMATEL for SHSCPM just only for determine the level of importance, level of influence and supplier selection on the sustainable supply and used to design a strategy map based on relationships between perspective and indicators. Then, integration DEMATEL and ANP for performance measurement can be used to determine the weights of perspectives and indicators based on their inner and outer dependence where the DEMATEL is used to relate indicators and perspectives and then the relationships created are used to make the ANP model. Finally, the ANP model can determine the weights of perspectives and indicators based on their inner and outer dependence.
Point 2: What are the main limitations of this approach?
Response 2: Please provide your response for Point 2. (in red)
(394 – 398)
Limitation of SHSCPM model by combining BSC with DEMATEL and ANP had explain on future research which SHSCPM system needs a new design with a simulation of system dynamics for predicting SHSC performance in the future based on the strategy map, weights of performance indicators and performance values in the past. The new design can help the healthcare business to prepare better its operations in order to achieve a high performance of the SHSC.
Point 3: How decision or policy makers can benefit from this work
Response 3: Please provide your response for Point 1. (in red)
(379 – 386)
Implementation of SHSCPM by integration of BSC with DEMATEL and ANP can make management of the healthcare business more attention to human resources as intangible asset, especially for innovation and organization behavior because most influence to other indicators. Beside, the management of the healthcare business must be maintain of customer satisfaction, patient loyalty, collaboration with supplier and stakeholder satisfaction as parts of social aspect for performance increasing. The SHSCPM model by combining BSC with DEMATEL and ANP can help management in the healthcare business to manage the company performance with simultaneously attention to intangible and sustainability aspects
Point 4: The managerial implications from this research deserve much more in-depth discussion.
Response 4: Please provide your response for Point 1. (in red)
Thank you. We have added more in-depth discussion on lines 379 – 386.
Point 5: As usual a final thorough proof-reading is recommended
Response 5: Please provide your response for Point 1. (in red)
We have done proof reading to Proof-Reading-Service.com, a professional proof reading, UK. If needed, we will request a certificate to Proof-Read service.
We include the following receipt and email from Proof Reading Service, UK.
Author Response File: Author Response.docx
Reviewer 3 Report
The topic of the paper is quite actual because supply chain philosophy gets a bigger interest in all economic subjects (especially in the case of providing public services such as healthcare). Unfortunately, the paper does not include an adequate description of the applied statistics method.
Authors present statistics results (tables 4,6,7,8,9), but there is not obvious, which method they used. there is only mention of ANP usage. Therefore, it is not possible to evaluate the presented results.
Authors talk about inner and outer dependence (line 229), but they do not explain, how the dependence was defined.
Author Response
Response to Reviewer 3 Comments
Point 1: The topic of the paper is quite actual because supply chain philosophy gets a bigger interest in all economic subjects (especially in the case of providing public services such as healthcare). Unfortunately, the paper does not include an adequate description of the applied statistics method
Response 1: Please provide your response for Point 1. (in red)
The application of statistics methods applied in the design of the SHSCPM by DEMATEL and ANP.
(206 – 233)
DEMATEL used for design of strategy map. Survey result were processed to the DEMATEL steps. Survey to identify level of influence between perspectives and indicators with 0 – 4 scale (0 = no influence, 1 = low, 2 = normal, 3 = strong, 4 = very strong). Stages of the DEMATEL methodology:
1. Building direct relation matrix (A) based on average of influence value from ai to aj.
2. Building normalization matrix (X)
X = A x s
3. Building total relationship matrix (T),
; I as identity matrix. Calculating of importance level and influence level of perspective and indicator.
Element of T = ; where, i = rows and j = column
D and R represent direct and indirect relationships from row and column.
Where, (D + R) indicates level of importance and (D – R) indicates influence level.
4. Building significant matrix to describe relationship between perspective and indicator. Steps to prepare for significant matrix:
- Calculation of average of T :
; Where, i = sum of row and j = sum of column
- Reduction of all T with or (T - ), value of significant matrix indicate level of relationship
5. The significant matrix describe of relationship between perspectives and indicators. Relationship between perspectives and indicators are made into a BSC strategy map which used for ANP structure model.
(256 – 263)
Step of ANP:
Survey used to pair-wise comparisons between perspectives and indicators on with scale of 1–9. Survey used to perform pair-wise comparison between indicators with scale 1 – 9. Survey results were processed to ANP steps. The validity of the pair-wise comparison could be considering of the inconsistency value. If value of inconsistency < 1 so the pair-wise comparison is valid. The ANP using initial matrix based on average value of survey result.
Weight calculation of perspectives and indicators on ANP can be process by inputting of average values of pair-wise comparison to software of super decision version 2.8.0. The value of the consistency ratio can also be seen directly in the super decision software after values of pair-wise comparison inputted to software system.
Point 2: Authors present statistics results (tables 4,6,7,8,9), but there is not obvious, which method they used. There is only mention of ANP usage. Therefore, it is not possible to evaluate the presented results
Response 2: Please provide your response for Point 2. (in red)
(260 – 263)
We used super decision software version 2.8.0 process data of pair-wise comparisons between performance indicators. The software is open source.
Point 3: Authors talk about inner and outer dependence (line 229), but they do not explain, how the dependence was defined
Response 3: Please provide your response for Point 1. (in red)
(265 – 268)
Inner and outer dependence were designed by relationships between perspectives and indicators as significant matrix. Inner dependence is relationship between indicators on the same perspective. Outer dependence is relationship between indicators with other indicators on the different perspective.
(273 – 282)
Besides, for performance indicators on inner and outer dependence can explain by examples: demand indicator (X1) on the financial perspective has inner dependence with effectiveness (X2), efficiency (X3), profit (X4) and revenue (X5), and then, indicator of demand (X1) has outer dependence with indicators on the customer perspective i.e.: quality of service (X6), delivery (X7), customer satisfaction (X8), patient loyalty (X9) and stakeholder satisfaction (X10). Furthermore, the organization behavior indicator (X29) on the innovation and learning perspective has inner dependence with capacity and professionalism (X24), innovation (X25), training and education (X26), research and development (X27), and health and safety (28). Beside, the organization behavior indicator (X29) on the innovation and learning perspective has outer dependence with all of indicator on the other perspectives.
Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
The revised version of the manuscript entitled “Integration of balanced scorecard, DEMATEL and ANP for measuring performance of sustainable healthcare supply chain” (Manuscript ID: sustainability-526477) improved significantly, whereas the author(s) provided proper explanations. Hence, the paper is worth publishing. Therefore, I recommend paper acceptance in current form.
