فهرست مطالب شایان شاپوریان

One of the most effective services provided by the armed forces during social crises (such as war, etc.) is the construction of military field hospitals. The location and construction of these hospitals have potential risks that need to be identified, prioritized, and find appropriate solutions to contain them. The purpose of the current research is to identify the risks of building military field hospitals during war and crisis and to prioritize them using the FMEA approach. The research is based on the method of data collection, descriptive-case study, and based on the type of data, it is mixed. The research expert team includes 17 experts (all of whom were familiar with the basics of risk management, field hospitals and the FMEA approach and had experience or academic records of more than 20 years, related to one of the mentioned subjects) using the available method and until reaching the theoretical saturation stage was selected. In order to survey the experts, a semi-structured interview was used. The first researcher-made questionnaire was used by the expert team to calculate the CVI index, and the second researcher-made questionnaire was used by 60 experts in the research field for the FMEA approach. The validity of the questionnaires was confirmed using content validity and its reliability using Cronbach's alpha and SPSS software. Based on the results, 60 priority risks (including 16 high-risk cases, 26 medium-risk cases, and 18 low-risk cases) were identified in the establishment of military field hospitals. Also, the results show that the risks of lack of drug storage, blood supply bank, operating room equipment, engine house, water tanks and facilities, health and energy infrastructure, land quality, waste disposal system, structure strength, camouflage and security of transmission routes are the most important risks.

One of the effective solutions in managing the crisis and improving the resilience of the affected areas is to benefit from military field hospitals. This is despite the fact that there are various risks during the establishment of such hospitals, and the development of effective management strategies for such risks can lead to the improvement of the resilience of areas affected by the crisis. The present research is based on the method survey-descriptive, and based on the nature of the data, it is mixed. It is also practical. For this purpose, in the first stage, after calculating the risks, they were screened using the content validity index. In the second step, the screened risks were classified into three categories of low risk, medium risk and high risk using the combined approach of "FMEA and AHP". Comparing the results with the results of risk assessment using the classic FMEA, indicates the high efficiency of the proposed method. Based on the results of these two steps, the risks related to the lack of access to energy infrastructure, patient transfer route, change of construction site, lack of operating room equipment and lack of access to the waste disposal system are the five most important risks identified with high weight. In the third step, using the combined approach of "AHP and SWAT", the strengths and weaknesses of military organizations in the construction and establishment Military Field Hospital and based on its results, nine strategies and eleven implementation solutions was proposed.

One of the most obvious aspects of successful management and planning during the imposed war was the management of aid to the wounded in the form of establishing military field hospitals with passive defense approaches. So that the aforementioned action was developed from creating a tent or a roofed frame for relief at the beginning of the war to the construction of field hospitals in terms of passive defense requirements. In this way, the average duration of sending war wounded during the holy defense period in some fronts of the battle of right against falsehood to medical centers was reduced to less than one hour at the end of the imposed war, and by complying with the requirements of passive defense. Various factors are effective in the construction and establishment of a field hospital, which can lead to the improvement of the hospital's performance and reduce the risks of its construction and establishment while meeting the requirements of passive defense. Identifying these factors in the form of a scientific model during the occurrence of civilian crises in the construction and establishment of a civilian field hospital with a passive defense approach is also of great importance. The current research was conducted to identify the relationship between these factors to facilitate the management and provision of services to the wounded during the war and possible crises with the approach of passive defense. For this purpose, a main hypothesis and nine sub-hypotheses were designed and tested. This research is applied in terms of purpose and descriptive correlation in terms of method, in which exploratory structural equations were used. The statistical population includes military-scientific experts, 17 of whom were selected by purposeful sampling and the Delphi method until theoretical saturation was reached. The data collection tool is a structured interview method and a researcher-made questionnaire consisting of six dimensions, 11 factors, and 66 measures. Confirmatory factor analysis and PLS software were used to test the hypotheses. The results of the measurement model criteria (measurement reliability criteria, measurement model reliability, and divergence convergence of the model constructs) as well as the structural model criteria (determination coefficient criteria and model prediction suitability) indicate the optimal fit of the proposed model. Also, based on the t-value results, the main hypothesis and all sub-hypotheses were confirmed. The results indicate the direct effect of the "quality of management and command of the field hospital" dimension on the dimensions of "providing financial resources for providing specialized identification and treatment equipment", "providing general and specialized infrastructure of the field hospital" as well as "providing human resources of the field hospital". Of course, the "field hospital management and command quality" dimension has the greatest impact on the "field hospital treatment quality" and "field hospital readiness and support quality" dimensions. Also, the results showed that in addition to the dimension of "field hospital management and command quality" directly, positively, and significantly affects the dimensions of "providing general and specialized field hospital infrastructure" as well as "providing field hospital human resources"; The dimension of "providing financial resources for the provision of specialized identification and treatment equipment" also plays a full mediating role in these two relationships.

One of the most important challenges at the time of war is the timely treatment of the war wounded and avoiding the reduction of combat power, which is usually solved by building field hospitals. The armed forces of the Islamic Republic of Iran gained valuable experience in the construction of field hospitals during the sacred defense period. The location and construction of these buildings along with the innovation, initiative and scientific creations of the fighters of Islam has developed.From the establishment of a tent or the construction of a roofed frame for relief in the beginning of the war, it turned into the construction of explosion-proof field hospitals with concrete structures camouflaged deep in the ground. So that by doing these creations, the index of "average time to send the wounded to medical centers" which was 14 days in the First World War, three days in the Second World War and 12 hours in the Vietnam War; After the construction of well-equipped and safe hospitals in the closest distance from the front line, it was reduced to three hours. This indicator was reduced to one hour with the construction of Imam Sajjad (a.s.) field hospital in Faw front (Valfajre 8) and to less than half an hour at the end of the war with the construction of numerous centers. Of course, due to reasons such as time constraints, along with the severe lack of specialized tools and equipment for the construction of field hospitals, some of the principles of passive defense are ignored in the selection and construction of these valuable structures. Because it is important to examine the strengths and weaknesses of these hospitals and especially the types of their structures, taking into account aspects of passive defense to build better field medical centers in the future; Therefore, the current research has identified and prioritized the effective dimensions, factors and indexes in the construction of field hospitals, taking into account the aspects of passive defense. For this purpose, the method of structural equations was used with SPSS software and Friedman's non-parametric test. The ranking results of field hospitals evaluation criteria, taking into account passive defense criteria, indicate that the criterion "the need to pay attention to the issue of location" in the security risk subgroup, as well as the criterion "the need to pay attention to the ability to change the location of field hospital structures" in the construction risk subgroup and structural infrastructure have the highest priority with an average rating of 20.12 and 18.79, respectively. At the end, suggestions were made for building more qualitative field medical centers by considering aspects of passive defense in future battle scenes.