Fatemeh Sadat Vahabzadeh Moghadam, Ahmad Vedadi, Karam Allah Daneshfard,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: A fearless organization fosters psychological safety, ensuring that every member feels secure to express concerns, ask questions, or share mistakes without fear of humiliation, ridicule, or punishment. This research aims to introduce the Fearless Organization Model in Iran's healthcare sector, with a focus on the Ta’amin Ejtemaie hospitals.
Methods: This research employs a mixed-methods approach. In the qualitative phase, methods such as meta-synthesis, expert Delphi, and Shannon’s entropy were used to identify the components of a fearless organization. The quantitative phase involved structural equation modeling (using surveys distributed among the staff of Ta’amin Ejtemaie hospitals in Tehran) to validate the research model.
Results: The Fearless Organization Model consists of two main dimensions: “Behavioral” and “Structural.” The behavioral dimension includes "managers' behavioral components" and "employees' behavioral components." The structural dimension includes "organizational components," "human resource components," and "environmental components." Key characteristics of a fearless organization include: creating psychological security, openness, transparency, accountability, humble listening, quick employee feedback, learning from mistakes, encouraging knowledge sharing, avoiding silence, and promoting open communication. Effective response systems and coherent organizational structures for extracting ideas and concerns, as well as fostering a supportive culture, are essential.
Conclusion: The findings of this study emphasize the importance of addressing both behavioral and structural dimensions in creating a fearless organization. However, the behavioral dimension plays a more significant role than the structural one. Within the behavioral dimensions, "employee behavior" is the most crucial factor. Managers should focus on cultivating behaviors that promote security and openness within the organization. This research can serve as a foundation for further studies on the drivers and barriers to establishing fearless organizations in different contexts.
Shahrzad Rasekhi, Sedighe Sadat Tabatabaei Far, Abdosaleh Jafari,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: This study aimed to review the average waiting time of patients referred to emergency departments in Iran and to identify the key factors influencing it.
Methods: A systematic search was conducted in scientific databases including PubMed, ScienceDirect, ProQuest, Scopus, Web of Science, Magiran, and Civilica using keywords such as "waiting time", "duration", "emergency", and related terms. After applying the inclusion criteria, 26 relevant studies were selected for analysis.
Results: Findings from this rapid review showed wide variations in reported waiting times. The average time from patient arrival to the first physician visit ranged from approximately 2 to 32 minutes. The time to the first medical intervention ranged from 3.7 to 262 minutes. The time from diagnostic test request to receiving results ranged from 20.17 to 629.2 minutes for laboratory tests, 5.85 to 1080 minutes for radiology, and 3.7 to 32.3 minutes for electrocardiograms. The most significant factors affecting patient waiting times included patient-related characteristics, reasons for referral, hospital and emergency department-related factors, and human resource availability and performance.
Conclusion: Patient waiting times in emergency departments are influenced by a range of interrelated factors. To reduce delays, it is recommended to improve triage systems, enhance human resource management, implement smart technologies, upgrade infrastructure, and increase public awareness through patient education.
