Identifying and Prioritizing the Factors Influencing Organizational Voice at Zanjan University of Medical Sciences Using the Fuzzy Delphi Method

The aim of this study was to identify and prioritize the factors influencing organizational voice at Zanjan University of Medical Sciences using a mixed qualitative–quantitative approach and the fuzzy Delphi method. In the qualitative phase, 23 experts and university managers were selected using snowball sampling. Through semi-structured interviews and a review of the literature (both domestic and international sources), 14 key factors were extracted across three dimensions: individual (including self-confidence, intrinsic motivation), organizational (organizational culture, organizational acceptance, organizational levels), and social (team spirit, social interactions). In the quantitative phase, these factors were evaluated through three rounds of the fuzzy Delphi method using Likert scale-based questionnaires. The significance of the factors was confirmed with a defuzzification threshold of ≥ 4. The results indicated that organizational acceptance, organizational levels, and organizational culture held the highest priorities, while self-confidence and team spirit also showed considerable influence. These findings underscore the need to redesign managerial structures and strengthen a participative culture within the bureaucratic environment of the university. The results can assist managers in formulating policies aimed at reducing organizational silence, fostering innovation (such as ideation for improving healthcare services), enhancing inter-organizational communication, and implementing training programs (such as participative leadership and change management workshops). This study can also serve as a model for other universities of medical sciences.