Jan. 26--Officials at Santa Clara County's public hospital are considering the removal of protective glass that rings the registration desk of the emergency department -- despite concerns from some staffers about decreased security.

With a growing patient load at Valley Medical Center's emergency room, clerks say they worry for their safety, and the hospital's former security chief offers a strong admonishment.

"From incidents I can recall, if glass hadn't been there, there would have been injuries to staff," said Mark Mooring, a court-qualified expert on health care security who has consulted for more than 60 hospitals. "Those individuals, seeing a ready path over the counter, would have taken it."

But a committee of hospital staff and consultants says the higher volume of patients is a reason to make the change. The consultants, who are charged with increasing efficiencies in county operations, are weighing whether the security glass hinders patient flow and whether it is "customer-friendly." A final decision is months away.

VMC is not unique in its potentially explosive waiting room, where frustrated patients often scream, curse and bang their fists -- or occasionally worse. Other local hospitals feature floor-to-ceiling glass barriers in their registration and triage areas; some even require walk-in patients and visitors to pass through metal detectors.

Gwen Anderson, an emergency department clerk at VMC for 16 years,

said she saw enough incidents before the glass was installed in 2003 to know it's needed.

An extensive study following years of employee complaints prompted installation of the impact-resistant glass around the registration area.

"People come in, they're angry about not having a job, they're angry about losing their insurance and losing their home," she said. "And a lot of them are having to come here for the first time."

Heavier workload

Indeed, the San Jose hospital's emergency patient load is almost double what it was just four years ago. As the provider of last resort, VMC must treat any patients who come through the doors, regardless of ability to pay. Today, 300 people each day seek emergency care in the 24-bed department -- and thanks in part to the county's financial straits, no additional staff has been hired to accommodate the influx.

Thus, moving patients as quickly as possible through the emergency department is a central priority. In 2007, county supervisors looking to cut costs approved a $20 million contract with Deloitte Consulting to work with staff on recommending efficiencies.