By John Hawkins, President & CEO, THA
It’s not uncommon for the Texas Legislature to lay an unusual issue at our feet, something that’s never been a point of contention in our work at the Capitol. In the first days of the Legislature’s 89th session, which kicked off on Jan. 14, we find ourselves addressing something we don’t normally touch on with lawmakers: bollards.
While “bollards” isn’t a widely recognized word, they are something people encounter every day. Commonly in the form of sturdy, vertical posts made of concrete or steel, their purpose is to protect people and buildings from vehicle collisions. They’re often found in areas with high pedestrian and vehicle traffic, such as grocery stores, shopping centers and government buildings. In the context of hospitals, this new issue illustrates the uniqueness of hospitals as institutions – and why one-size-fits-all mandates on our facilities are often a misguided idea.
Lawmakers drew attention to these safety devices following a tragic incident last February when a vehicle slammed into an emergency room at St. David’s North Austin Medical Center. The driver – found to have a blood alcohol level more than three times the legal limit – died in the crash and injured six others.
Reactions to the tragedy led to a notion that every hospital in the state should be required to install bollards to solidify their infrastructure. While the hospital where the accident occurred has since installed bollards, it did so after evaluating its own circumstances. Recently filed Senate Bill 660, would require all hospital emergency rooms near vehicular traffic to install bollards or other safety barriers. This well-intentioned notion, however, takes the evaluation and decision-making process away from hospitals.
Currently, no state or federal law exists requiring hospitals to install security bollards, and for good reason. Tragedies like the one that occurred at St. David’s are not specific to hospitals. Just last month, a teacher was killed and five children were injured after a car crashed into a playground area at a San Antonio elementary school.
In fact, data collected since 2014 by the Storefront Safety Council (SSC) shows that crashes involving medical facilities likely make up less than 1% of the vehicle-into-building collisions in the United States. Additionally, crash data on medical facilities are not specific to hospital emergency rooms. It’s not clear based on published data how many crashes have directly occurred at emergency room entrances.
Statistics listed on the SSC website indicate the most common locations for these types of crashes are retail stores and restaurants. Other frequent locations include commercial buildings, offices and convenience stores. Despite the high frequency of vehicle-into-building crashes at those building types, there’ve been no efforts by Texas lawmakers to require bollards in these locations.
It’s important that we do everything we can to protect our communities, but it’s also important that in doing so, we don’t create challenges that threaten the survival of other important safeguards. Vehicle-into-building crashes are undeniably tragic, but we’ve yet to see any national studies or scientific evidence that show prevention of these incidents is a pressing, critical need for hospital safety. Access to high-quality health care within close proximity is already a challenge in many corners of Texas, especially for our rural communities. Singling out hospital emergency rooms to install bollards would not prevent the overwhelming majority of these crashes; however, it could negatively impact that access.
From large systems to small rural facilities, hospitals across the state are facing unprecedented financial challenges. With nearly one out of every 10 Texas hospitals at risk of closure, a mandate for bollards is an unreasonable administrative cost burden that could impact access to care – and the cost of care – for many Texans. It’s crucial that hospitals be allowed to independently assess safety measures based on the needs of their communities.
As we embark on these pivotal next few months of lawmaking, THA welcomes conversations with lawmakers interested in patient safety, including the development of reasonable policies that consider the uniqueness of each hospital and its community. We must always strike an important balance: maintaining the highest standard of care while protecting patients and ensuring hospitals have the flexibility to respond to their own circumstances.