Faruq, Quazi Omar (2018) Management of training to prevent occupational violence: a case study of the Work Health and Safety Management System (WHSMS) in a hospital in Victoria. Other Degree thesis, Victoria University.

Abstract

Healthcare is a complex arena of multi-skilled interaction. In recent years, it has grown extensively out of the simple act of treating the sick by a noble healer to taking measures of preventing illness not only of the clients but also of the community. It is no more a deal between two persons: the sick and the healer (like a doctor). Community healthcare is regulated by several agencies including legislative agencies (like government, international health organisations), professional bodies, industrial regulators, consumer advocates and commercial entities (such as insurance companies and pharmaceuticals). Healthcare service providers or professionals are not the sole regulators rather their actions need to balance the legal obligations to the client (such as client satisfaction), to staff (such as workplace safety) and to business (to maintain competitive advantage in the industry). Current healthcare service provision is challenged by many factors including diversification of the task, diversity of workforce characteristics due to globalisation and increased service demand by knowledgeable customers searching proactive healthcare and not just curative care. To overcome these challenges along with maintaining quality service, organisations need skilled staff. This, however, is threatened by occupational hazards like occupational violence against staff (OVAS) which is well documented globally and across Australia. The impact of OVAS is not limited only to disruption of service but also to the quality of service and shortage of human resources in some cases. Regulatory agencies like the Department of Health, Comcare, Safe Work Australia and Worksafe Victoria (VAGO, 2013) are providing guidelines on OVAS management. Most healthcare providers are considering some actions, but not with any universal consensus. According to the hierarchy of control in Work Health and Safety Management System (WHSMS) a hazard could best be controlled by eliminating it, but if not then training of staff is an option. Training will always be needed whether or not other measures of hazard and risk control are implemented. This encourages research to develop effective training in terms of trainers’ perspective (in delivery), learners’ perspective (of appreciating the sessions) and management’ perspective (of the outcome of hazard control). Literature shows that the workforce training in hospitals to control OVAS lacks consistency and uniformity across Australian hospitals. ‘Management of Violence and Aggression International Training’ (MSVT) is one training programme run by the BN123 Health, Victoria, since 1990. With that background the main aim of this qualitative case study research project was to “identify the effectiveness of the existing training programme (MSVT) in prevention of occupational violence against staff (OVAS) “. Occupational violence is a part of work health and safety issue. So, the research intended to enquire: ‘Is the existing MSVT in prevention of OVAS achieving its purpose, particularly in the current WHSMS setting of the hospital?’ The literature review assisted in identifying the causes of OVAS, types, prevalence and the factors associated with it. It also helped to analyse the published incidents. Among different training evaluation methods, the Kirkpatrick’s model was found most suitable to evaluate MSVT. Analysis attempted to correlate the outcome of the training against existing objectives. Limited access to information meant that I could not perform in-depth analyses, but the findings of this study are expected to guide future research on the effectiveness of MSVT at BN123 Health with more integration to the WHSMS and other safety programmes This research used a qualitative case study with Actor-Network Theory (ANT) to fulfil the goal. The limited access to health facilities both due to obstacle in sensitive data collection and accessing busy participants of different sections of the hospital in a limited time frame. This study explored actors related to OVAS and suggested adoption of an innovative approach to improve workplace safety through the formation of new networks. It did this by looking through the lens of Actor-Network Theory (ANT). The present vision of the government in digitalising the health sector in Australia is a prime opportunity to re-align the network in the WHSMS of the hospital for better impact of training on the OVAS situation. Limited guidance from top management was an issue. MSVT was under the control of the Psychiatric Department at its inception but was then moved under Human Resources (HR), which seems to have reduced its importance and resource management ability. Hospitals are dominated by clinical priorities rather than HR issues. Being a part of the general training programme administered by HR has limited the ability of MSVT as it struggled to receive funding to recruit enough full-time trainers to undertake research on OVAS incidents, promote the programme across the whole organisation, publish materials to create awareness to all staff and develop resources to help retain the knowledge of the participants in the post-training period. Limited flow of information on OVAS was another issue. Even though BN123 Health invests in innovation like RSKSOFT, for reporting it did not purchase all the modules of that programme to improve the flow of information to the trainers of MSVT. BN123 Health demonstrated a proactive attitude in managing OVAS by procuring and trademarking MSVT but is lacking continuity of efforts in it, maybe due to its commitment to clinical aspects of the service. This could be verified by further research. The research identified scope for innovation. Firstly, the training programme could be strengthened by incorporating recent updates on organisational objectives and legislative changes and standardisation with industry practices. It could also be strengthened by incorporation of an improved audio-visual component, distance learning facilities for beginners and refreshers, updating resources including books and journals, inter-organisation exchange programmes and inclusion of regular research results in booklets and handouts. Targeted delivery would also assist, with constant vigilance on incidents and inclusion of vulnerable groups in training. Another worthwhile innovation would be to change the focus from staff only programmes to involve customer or client interest. This could include arranging training for clients and carers as they are a party in the conflict. Management training would be useful to prepare resources for the population of the catchment area, bringing together all healthcare providers (including GPs) who refer clients to the hospital. Updating real-time information collection, storage and analysis by professionals as well as information access to trainers would also be a worthwhile innovation. With the availability of mobile technology, BN123 Health has scope to improve its ability to get real-time information from the incident spot and to develop better management to control events. This could also provide arrangements for easy data entry by general staff.

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