Doctors, nurses and staff at Ballarat Health Services are subjected to rates of violence in the workplace much higher than other health care settings across the state.
According to the 2018-2019 BHS Annual Report, tabled in state parliament last week, there were 1612 incidents of violence reported to management.
While it was a drop from the previous year's total of 2186 incidents, the rate of 53.91 incidents per 100 full time employees was double that of the workforce of Barwon Health in Geelong (26.81 per 100 FTE), and almost three times higher than in Bendigo (20.4).
According to the annual report, one in 20 occupational violence incidents at BHS resulted in a staff injury, illness or condition - and the average cost per claim more than doubled to $15,562 in 2018-19, up from $6221 the previous year.
Federation University Associate Professor Danny Hills, who has studied workplace aggression for almost 20 years, said occupational violence in the healthcare setting was "systemic".
"I think there's just a lot of disrespect out there in community for health workers these days," he said.
A Ballarat Health Services (BHS) spokesperson said BHS "does not tolerate aggression against our staff and is committed to providing a safe and healthy workplace.
"Significant work has been done to improve the reporting of adverse events relating to violence and aggression directed towards staff by patients and residents.
"Our Protected Disclosure Program has seen a doubling of reported incidents of occupational violence.
"We have also increased our resourcing of activities that focus on prevention and de-escalation, equipping our staff to identify early changes in an individual's behavior, alerting staff much sooner to the possibility of increased aggression."
BHS also offers Management of Clinical Aggression training to other health services in the region to help reduce their rates of occupational violence.
The annual report showed 1304 BHS staff members had undergone the MOCA training, aligning with their strategy to ensure all staff who have contacts with patients and visitors undergo occupational violence training annually.
But Mr Hills suspected the real rate of occupational violence in hospitals and health care settings was even higher than reported, with many workers he spoke to not reporting incidents because "the reporting system is too onerous and nothing ever gets done".
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Patients and families, particularly in an emergency department type setting, could often escalate over waiting times, communication and other issues.
Mr Hills said fear of aggression in the workplace impacted on the health and wellbeing of staff, which in turn could affect the quality and safety of patient care.
"Workplace aggression in the health and care sectors is a major work health and safety, and public health concern, especially in non-metropolitan settings," Mr Hills wrote in his research paper Workplace aggression experiences of Victorian nurses and midwives in non-metropolitan settings, which he presented to the 15th National Rural Health Conference in March.
"More targeted and effectively operationalised legislation, policy, incentives and penalties are required to prevent or minimise the likelihood and consequences of this truly wicked problem."
Mr Hills' research, which surveyed more than 1200 nurses and health care workers, found aggression was most likely to come from patients, their relatives or carers, then coworkers.
Exposure to verbal or written aggression was much more prevalent than exposure to physical aggression, but rates were very high for both forms of aggression.
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