Finding the Creative Synergy between Spiritual Care and the Schwartz Rounds
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsExploring Shwartz Rounds is sound. There is a wide knowledge of the method, but not a lot of participating institutions. Your readers would benefit to understand how this theory could be implimented in smaller hospitals and congregant care communities
Author Response
Thank you very much for taking the time to review our manuscript. Please find the detailed responses below and the corresponding revisions highlighted in the re-submitted files. Comments 1: There is a wide knowledge of the method, but not a lot of participating institutions. Your readers would benefit to understand how this theory could be implimented in smaller hospitals and congregant care communities Response 2: Thank you for your comment, We agree that the Schwartz Rounds are better known in some countries than others. The Rounds are run in over 500 health facilities and the program is supervised and administered internationally from the Schwartz Centre in Boston or Point of Care in the UK and Ireland. We have, accordingly, added some additional information on page 6, at lines 232-237. The additional lines read, "Schwartz Rounds are conducted across hundreds of health facilities in the United States, Canada, The United Kingdom, Ireland, Australia and New Zealand. The program and training are administered through licensed agreements with the Schwartz Centre in Boston, MA. Rounds are run by a leadership team across large health organisations, and in smaller facilities such as hospices or as unit-based rounds."
Reviewer 2 Report
Comments and Suggestions for AuthorsFirst of all, I can say that this is a very interesting article with a top which taps into a reality which is being given great importance only in the last few years. Well done on that note!
At times, you were mentioning the outcome of your research but it was not always clear how this outcome relates with your arguments. This would make for a more seamless integration of the description of your research and its outcome, together with the description of the Schwartz Rounds and their implications. So, this part needs to be further enhanced.
Also, on a side note, please pay attention to sentence structure. Overall the use of English is good, but at times there are some mistakes which would need due revision.
Comments for author File: 
Comments.pdf
The English language use is good on the whole. However, there needs to be some revision regarding the sentence structure. Also, some sentences are a tad too long. They need sub-division through full stops, rather than commas.
Author Response
Thank you very much for taking the time to review our manuscript and your encouraging words. Please find the detailed responses below and the corresponding revisions highlighted in the re-submitted files. Comments 1: The template details the sections that can be used in a manuscript. Note that each section has a corresponding style, which can be found in the “Styles” menu of Word. Sections that are not mandatory are listed as such. The section titles given are for articles. Review papers and other article types have a more flexible structure. Remove this paragraph and start section numbering with 1. For any questions, please contact the editorial office of the journal or [email protected]. Response 1: Thank you for this recommendation. Based on your feedback, we have separated the paper in two parts. Part I comprising section 2-6 comprising background material and Part II, the discussion around the synergy between spiritual care and the Schwartz Rounds. The editorial team at mdpi has said they will reformat the paper to meet these requirements. (notes at top of page 7) Comment 2: At times, you were mentioning the outcome of your research but it was not always clear how this outcome relates with your arguments. This would make for a more seamless integration of the description of your research and its outcome, together with the description of the Schwartz Rounds and their implications. So, this part needs to be further enhanced. Response 2: Thank you for these comments. We agree and, therefore, have added two additional paragraphs during and at the end of Part I to explain how our previous research relates to this paper. In our experience, the Rounds has created a third space where healthcare staff and spiritual care practitioners connect on a equal footing as colleagues, focusing on similarities rather than differences. Through the Schwartz Rounds, staff experience compassionate care that attends to the spirit and soul of staff and patients. (page 7, 295–299) Our initial studies of the Rounds in an urban [country redacted] setting demonstrated benefits for staff. In the shared experience of the Rounds, staff reported that they felt connected and not alone and they were more able to understand other people's roles. Participating in the Rounds normalised and validated their experiences, providing a safe space for vulnerability and authentic conversation. We observed that some of the optimism expressed to the Rounds were in response to the highly structured Schwartz process, active facilitation, consolidation of the safe space and panellist preparation. This paper provides further perspectives and reflections on theoretical synergy and practical elements that we believe underpin the positive assessment of our Rounds by the participants. (page 8, lines 322-330) Comment 3: Also, on a side note, please pay attention to sentence structure. Overall, the use of English is good, but at times there are some mistakes which would need due revision.
Comment 3a: First, second, third, etc
Response 3a: We agree that the traditional (Fowlers) numbering convention first, secondly, thirdly is not commonly used and we have changed these to first, second, and third, (page 2 and lines 60-63 and page 11, lines 467-69) Comment 3b: The English language use is good on the whole. However, there needs to be some revision regarding the sentence structure. Also, some sentences are a tad too long. They need sub-division through full stops, rather than commas.
Response 3b: We agree and have made the following sentence revisions and punctuation corrections: Page 2, line 73 Page 2, line 91 Page 3, lines 126, 132 Page 4, line 172 Page 5, 208-9 Page 7, 305
Page 8, 333
Page 12, 515
Page 14, 649 making the unbearable bearable, or bearing the unbearable are common phrases in spiritual care, a phrase used by Ken Schwarz himself. I have italicized the phrase.
Page 16, 727-729, has been rewritten to make better sense. We have highlighted all alterations and amendments in the text. Thank you again, from these authors, for your very careful engagement with our text and ideas.
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