مطالب

Objective : This research aims to propose a multi-criteria decision-making model for ranking hospital departments. The primary purpose of this model is to assist managers in the optimal allocation of limited resources, thereby reducing costs while increasing patient satisfaction. The ranking results help managers in decision-making processes such as equipment development, staff training, and addressing patient complaints. Methods : This study evaluated the performance of five hospital departments (Emergency, Ophthalmology, Cardiovascular, Infectious, and Neurology) in Shiraz, Iran, using the fuzzy DEMATEL-MARCOS multi-criteria decision-making method. Firstly, criteria were prioritized using the fuzzy DEMATEL method, after which hospital departments were ranked using the fuzzy MARCOS method. A sensitivity analysis was conducted to validate the results. Results : Performance metrics for the hospital departments were identified based on the Lean, Agile, Resilient, Green, and Sustainable (LARGS) paradigm. The results revealed that patient satisfaction and job satisfaction had the most substantial influence on performance, while reducing excess transportation and over-processing had the least impact. Utilizing the fuzzy MARCOS method, the hospital departments were ranked according to their overall desirability. The sensitivity of these rankings was assessed by adjusting the weights of the criteria. A comparative analysis with four other fuzzy methods (ARAS, COCOSO, EDAS, and WASPAS) confirmed that the fuzzy MARCOS method was the most effective tool for prioritizing hospital departments. Conclusion : The fuzzy MARCOS results indicated that the “Infectious Department” performed well, while the “Ophthalmology Department” required improvement. Enhancing the “Infectious Department” hinged on better staff training, cost reduction, and safe waste management. This research introduces a novel approach using the fuzzy DEMATEL-MARCOS model, enabling hospitals to assess performance through modern methodologies, such as Lean, Agile, Resilient, Green, and Sustainable, even in uncertain conditions

This study aims to identify the cognitive and emotional components of self-advocacy in exceptional learners and examine the external factors that influence their ability to advocate for themselves in educational settings. A qualitative research design was employed, utilizing semi-structured interviews with 29 exceptional learners recruited through online platforms. Theoretical saturation was reached, ensuring comprehensive data collection. NVivo software was used to conduct thematic analysis, identifying key cognitive and emotional factors related to self-advocacy. Participants shared their experiences regarding metacognitive awareness, decision-making, emotional regulation, and external support systems, providing rich qualitative data for analysis. The results indicated that self-advocacy among exceptional learners is shaped by cognitive competencies, including metacognition, decision-making, and information-seeking behaviors, as well as emotional factors such as self-efficacy, resilience, and emotional regulation. Participants who demonstrated strong metacognitive strategies and confidence were more effective self-advocates, whereas those facing anxiety or low self-efficacy struggled to assert their needs. External factors, such as educator support, family involvement, and institutional policies, played a critical role in shaping advocacy experiences. Online networks and digital advocacy resources were identified as valuable tools for enhancing self-advocacy skills. However, institutional barriers, including bureaucratic challenges and lack of awareness among educators, posed significant obstacles for learners. The study highlights the complexity of self-advocacy in exceptional learners, emphasizing the interplay between cognitive awareness, emotional resilience, and external support structures. Enhancing self-advocacy skills requires targeted interventions, including advocacy training, institutional support, and digital resource accessibility.