C Prevalence of OVAS and its Impact on workflow

As mentioned above the scarcity of data is a hindrance to find prevalence of OVAS at different industries. One study noted OVAS of physical aggression varied from 2% - 29% and of verbal aggression 15% - 75% (Hills, 2013). Another study found OVAS was 10% - 95% of which 20% - 40% was from relatives or patient’s carers (Alexander, 2004). Such data might help in understanding the presence of OVAS but not the reveal the extent of it and not provide help on the gravity of the

33 incidents. This would not help greatly in setting a priority of actions in any management planning. Besides those direct assessments, some indirect estimates could be made from the number of work- place absences and work-cover compensation claims lodged. There are also some data about the psychological or stress related absence from work (ABS, 2007), which might be related to OVAS, however the data does not specifically identify this link.

In one study, compared to other OECD countries Australian data showed a higher incidence of self- harm and homicide related to OV with an annual rate of around 4.88 per 100,000 workers (Chappell, 2006). This translates to around 0.07% of all workers per annum, or approximately one person a month murdered at work (Mayhew, 2005). But it is difficult to find any comparison on OVAS data across OECD countries, mostly due to lack of uniformity in defining the OVAS. In Australia in 2016, statistics show the following industries had high numbers and rates of fatalities and/or injuries: Agriculture, Road transport, Manufacturing, Construction, Accommodation and food services, Public administration and safety, and Health care and social assistance (Safework Australia, 2016). In some other developed countries also healthcare workers are more likely to face OV compared to other industry workers (Blando, 2015).

OVAS is now getting the attention of the regulatory bodies in Australia (VAGO, 2013, 2015). Initial focus was on the cause and category of violence but now it is drawing attention to its impact not only on the victim but also on service quality.

The impact of the OVAS varies depending on the incident and its severity. An incident might entail inflicting physical injury, psychological injury and influence behavioural and personality changes of the employee particularly when subjected to prolonged exposure or repeated incidents (Way, 2012). The ultimate effect of this is a loss of interest in work participation, errors in functioning, and a decline in productivity (Hills, 2012). That means that following an incident the victimised staff member may lose confidence or enthusiasm to treat patients and his/her work performance might reduce resulting in increased errors on the job. OVAS can even result in homicide (Chappell, 2006; Mayhew, 2007).

Impact of occupational violence includes diminished productivity, higher absenteeism and turnover, and court cases (Gates et al., 2011a; Gates et al., 2011b). Direct costs of workplace accidents include: Employee lost time, Medical and hospital costs, Compensation and Liability claims, Legal costs, Insurance costs, Replacement costs (for equipment, products, personnel). Like other workplace accidents, indirect costs of OV could be greater than direct costs and might include: Cost of work time lost by others stopping work, Cost of first-aid, Cost of equipment damage or product loss, cost of injured employee due to income loss, and subsequent administrative costs to the management in terms

34 of reporting to authorities like Worksafe Victoria (Hrymak, 2007; Safework Australia, 2012b;

Speroni, 2014). Responses to OV are subject to a person’s own perception (even those of doctors) of experiencing aggression from each source (Hills, 2012).

Awareness of the concept of hazard stimulates peoples’ understanding of the possible threat and of the need to take measures to minimise, even if appropriate management techniques are uncertain.

Sometimes people expect or apprehend some hazard, but the perception of risk is not high enough to consider the need for any corrective action. People of low socio-economic status, such as the

homeless or those of poor psychosocial status like drug addicts, face chronic malnutrition but many of these people would not be concerned that malnutrition will increase their proneness to infection. An individual’s knowledge and level of awareness is influenced by a range of psychological, social, institutional, and cultural factors (Outreville, 2003; Slovic, 2000). People with no knowledge about toxic agent or carcinogens would not bother to take preventive measures like handling the asbestos sheets or the lead-based paints before the 1950s. Before the 14th _{century how many countries were} concerned about sanitation, environmental hazard or ensuring supply of safe drinking water in the community? Impact of a hazard depends on several factors: awareness or knowledge of the hazard, perception or views or attitudes to the hazard and associated risks (Curcuruto, 2014) interest of the management to give value to the incidents (Swuste, 2010), participation of all stakeholders (like employer, employee, client or contractors) to implement the safety policy (Wilde, 2014).

Unfortunately people accept conclusions that fit with their social attitudes and preconceptions (Wilde, 2014), no matter whether it is right or wrong from a scientific point of view. That means perception on any issue usually depends on the social attitude or belief of any group of people at the workplace. That creates a difference in ‘perception of the hazard’ at floor level and management level, which was overlooked by many management (Huang et al., 2016; Morrow, 1998). Difference in perception allows people to take targeted risks that they feel would enable them to complete the task better, but in reality can bring severe impact on health and safety (Wilde, 2014). Such difference in perception is not helpful to create a safety culture or organisation-wide safe environment in any organisation. To reduce the impact of OVAS and for risk minimisation, developing a safety culture is more (Huang et al., 2016) effective than any punitive action.