Capítulo 4. Análisis de Resultados
4.2 Violencia Cultural y el Municipio de Suacha
An incident is not just the result of human or technological error but due to other factors including weakness of a system (Paterson, 2012) and the interactions of all of these factors. The discussion on the causes, types, incidences and prevention strategies of OVAS in the literature review helped identifying factors contributing to OVAS.
Literature on incidences of violence against different staff in hospitals adds more to the understanding of the interaction of actors. Key elements and themes of MIMOSA (Saracino, 2015, 2012), guide us to consider clusters of actors of OVAS and to understand the management of interactions even better. Among those factors some would be of such strength that they would influence the interaction among others to maintain a network. These are called as actors.
With the increasing complexity of sociotechnical systems, modern technology has changed the nature of human work from mainly manual tasks to predominantly knowledge intensive activities and cognitive tasks (Fan et al., 2015). This influences the development of a framework to consider the behaviour of human–machine systems in the context of the environment in which work takes place. According to the resource-based view (RBV) the competitive advantage of an organisation depends on the systematic management of its resources to gain cost-wise or, product-wise or, service-wised advantage (Ismail, 2011). In service-based action better performance is important.
Perception of hazard and risk depends on individual, community or organisations level of understanding on what is normal and what is disaster (Cardona, 2013). So what policy would be formulated and what would be adopted by the community and the organisation depends on the level of perception about a hazard. People working in a hazardous environment don’t consider anything as hazardous or to be cautious of. For example, traditionally a soldier was considered ready for a war if they fulfilled the age criteria or gender or showed the courage and learned the skill to use weapon. Question of death was not much important to the soldier as they considered it as a part of war. The invention of protective gear (Guyker, 2013) has encouraged leaders to include as an important resource to gain competitive advantage, but it requires extra fund and further training. This protective gear is a new non-human actor and affects how the new generation soldiers react, how it affects the national budget. Similarly in law enforcers (Geoffrion et al., 2015) and in hospital staff (Jessica, 2011) occupational violence is not considered as a risk as many considers it as a part of the job and doesn’t report.
68 Perceptions of safety and the adoption of OVAS management policy and procedures depend on the analysis of the interaction of different actors (Thompson, 2014). Raising the level of awareness is an important function to improve the level of perception among all workforces including management.
This study attempted to understand the adequacy of the training to fulfil its role supporting the risk minimisation effort of the WHSMS of the hospital. In doing so it attempts to understand the actors related to success of the training impacted by innovation and its outcome to match the target. The study also wished to suggest improvement by adoption of innovations.
Increasing presence of tools, technology and other non-human objects or machines in the work place it is not sufficient to understand the human attributes only to manage the performance. Today human and non-human factors are equally important, intermingled and indispensable to one another, for efficiency. Perception, a social factor, and technical knowhow determines the proper use of the tools or techniques. To manage that it is important to use sociotechnical approach (Booth et al., 2016). ANT is a conceptual lens and is an innovative perspective to examine that interaction. ANT is
complimentary to content analysis as it applies a social view on the interaction rather than considering the performance only of the human and that of the non-human artefacts. It is suggested that a merger of ANT ideals and perspectives with traditional research methods be considered (Booth et al., 2016).
Actor-Network Theory (ANT) suggests that the performance of any activity relates to human and hon-human elements of a network (Latour, 1996). These non-human elements could include technology, programmes, environmental factors and others that influence the events.
Understanding complex interplay of issues like regulatory compliance, organisational culture, innovation in training, adoption of the message in the work practice and measuring the performance of the WHSMS requires a socioecological approach (Young, 2010). Issues like violence in the workplace particularly by patients or their relatives or friends are also complex. This shows a need to understand not only the act of violence at the point of crisis but also the characteristics of the
perpetrator, the environmental factors, the activity of the staff at that point and the system of service delivery or management decisions. All these could be addressed by Actor-Network Theory.
ANT emphasises that ‘social interaction’ depends on the material and natural world which is missing in most social theories but is very important in studying the organising process of organisations (Latour, 2005). ANT differs from any social network conceptions demonstrated in sociology in that this theory emphasises that the networking is through linkages of human and non-human actors where all actors are in relationships to achieve a common goal, maintaining their individual aims or interests,
69 but are unable to exist independently. In an organisation heterogeneous actors like social and
technical issues come to play in a relatively stable alliance (Law, 1991a).
A factor or an element can’t be considered as an actor if it does not have any influence on the network either integrating or dis-integrating the system to form a new network (Callon, 1986). So, an actor is not only a part but an active element to maintain the relationship or to move it to the next level.
In ANT, the human and non-human (or artefact) actors have equal weight in maintaining the network but in conventional sociology the actors are usually defined as ‘discrete individual, corporate, or collective social units’ (Wasserman & Faust, 1994). The proponents of ANT mention that social relations are not independent of inanimate factors (programme, system, material, plant, machine, weather, and germs) but rather have equal value to the human actors (Callon, 1986; Whittle, 2008). Review of the literature suggests that Actor-Network Theory revolves around the concepts of actors, black boxes, networks, inscriptions, intermediaries and translation.
Many studies have used ANT as a science-based innovation process to analyse the actors’ roles in an event or behaviour or act (Young, 2010). The concept of ANT is well utilised to explain the
interactions of regulations, machines, workers and inspectors in workplace safety management (Gherardi, 2000). So, ANT was the appropriate choice to explain the OVAS control measures including success of the training.
The use of ANT in this research was further justified by examining the success of an anti-smoking campaign through the reform of networks of actors in a complex smoking culture and inclusion of policy innovation for better outcome (Young, 2010). Referring to Latour (2000), figure 6.0 explains how the actors are linked by knots in the black-box to maintain the network in a culture and how the actors shift the position to bring changes. This figure explains in that anti-smoking campaign changes happened through four stages to shift the actors from previous bonding to a new network. Figure 6.0 explains how reform of a system worked, that is implementing the smoke-free policy, through some key stages: mobilisation of instruments (and establishing the concept in the community), establishing the issue or the problem (called autonomisation in ANT terms), developing preferred solutions, contesting solutions against other views, institutionalising (implementing and refining) the preferred solution, alliance building and wining social acceptance (Young, 2010). Once the actors are identified ANT provides a theoretical framework for understanding, and guides to bring change in complex systems through innovation, like policy innovation. Innovation might result from role changes of the actors and formation of new networks towards change.
70 The actors in that anti-smoking campaign included people, research evidence,
technologies, financial resources, institutions and regulation (Young, 2010). Application of ANT helped the translation of the new solution among actors to influence the formation of a new network to influence changes in the smoking behaviour even quitting smoking. The new anti-smoking policy became the preferred solution, which stimulated the formation of new anti-smoking network. In ANT this is termed as ‘problematisation’ which means ‘identifying the nature of the problem’ (Callon, 1986; Fenwick, 2012). It also needed new alliance formation by institutional endorsement, public support and accumulating tangible and intangible resources. The balance of opinion loop (in the figure 6.0) means gaining the acceptance of individuals potentially affected.
The non-human actors (in figure 6) that contributed to the innovation in that anti-smoking campaign were (Young, 2010): intangible resources (e.g. scientific evidence and supporting theories) and tangible resources (e.g. technologies, money, and venues). In changing the past practice (that is smoking habit) to non-smoking the key resources were: knowledge gain about the problem through scientific evidence, theories that make sense of the evidence and technologies used to assess or solve the problems. The evidence and the theories (or ideas) that were mobilized ultimately reflected the interests of those engaged by an issue and were mobilized to serve their values and priorities.
ANT also discusses the scope of innovation in an evolving new network within the existing
programme to gain competitive advantage in a complex environment. The role of actors in influencing the adoption of innovation could well be explained through ANT (Latour, 2005).
The literature review (chap 2.1.F) showed that occupational violence involves the interaction of human and non-human actors. The association of these actors can be explained by Actor-Network
Figure 6, Implementing anti-smoking policy Latour's model of ANT (Young 2005, Fig 1)
71 Theory which is better positioned to map the relationship between material (things) and semiotic (concepts) actors (Callon, 1986; Latour, 1996; Law, 1987). This theory assumes that innovators attempt to create a forum, a central network in which all the actors agree that the network is worth building and defending. This theory does not differentiate between human and non-human elements of the network. As per this, an actor is any entity (human or non-human) that can make its presence individually felt by other actors (Law, 1991a). ANT will help an understanding of how and why some knowledge or practices are adopted in any organisation while others are not and will help to explain how a practice or innovation may be adopted by actors (in this study the employer or employee). There could be some moderators: type of hospital (high volume, acute or chronic care), customer demographic (age, sex, attitude to health service), work practices in the hospital, training of staff, counselling of staff or stress level.
To gain competitive advantage organisations attempt incorporation of innovative ideas. Literature suggests that management should understand the organisational behaviour while adopting an
innovation (Belanger, 2002; De Dreu, 2008). A new idea or technology once introduced may or may not be adopted or may only be adopted in part. Just because the new idea or technology exists is no guarantee that it will be accepted and adopted by all. This needs to be understood by management and passed to trainers so that training sessions don’t demand too fast implementation of any idea or knowledge.
Organisation can stimulate people or facilitate through right environment to develop work specific innovative ideas in house. Innovation results from the application of knowledge in developing new ideas, products or services and this in turn assists overcoming challenges (Thompson, 1965) thus benefiting the organisation and its stakeholders (Baregheh, 2009). An organisation can be a generator of innovation or an adopter of it, influenced by many factors such as environment or culture. Trainers can play an important role in such activities, provided management cater for it. In other words, ‘a training’ is not just demonstrating a few old tricks but to encourage people to come up with new ideas to overcome the challenges.
Knowledge management require opportunity for creation, guidance to overcome the challenges using that knowledge and controlling the flow of knowledge for the benefit of the organisation (Darroch, 2002). No matter whether the knowledge is explicit or implicit, its value depends on the accessibility and applicability at the right time, right place and for the right people.
Values, symbols and rituals shared by its members develop an organisational culture that becomes a powerful determinant of innovation (Dasgupta, 2009). On the other hand, negative perception of the people about any issue are the main barriers in knowledge management due to inhibition in
72 knowledge sharing and even, lack of interest in management or in leadership. These need
consideration in developing a training plan and to achieve a positive outcome of it.