1. March 2006 Addressing the Limited Data Dilemma Non-Traditional Sources of Safety Data Presented by: Terecia Wilson Director of Safety

2. March 2006 Traditional Data Collection  Crash Data  Driver Records  Vehicle Records  Roadway Inventory Data  Citation Data / Adjudication Data  EMS Run Reports

3. March 2006 Alternative Data Collection  Road Safety Audits  Opinion Surveys  Observational Surveys  Program Assessments  Interviews  SCP Forum (Data Guide)  CODES Data  Data Cube  Complaint Files  Program Evaluations  Professional Judgment

4. March 2006 A formal examination of an existing or future road or traffic project, or any project which interacts with road users, in which an independent, qualified examiner reports on the project’s crash potential and safety performance. What is a Road Safety Audit?

5. March 2006 Why Do RSAs?  Proactive approach to highway safety.  Widely used in other countries - highly effective.  Possible even with limited resources.  Supports Strategic Plan Goal of improving safety.

6. March 2006  Future Roads  Stage 1 – Planning  Stage 2 – Preliminary Design  Roads Under Construction  Stage 3 – Final Design  Stage 4 – Pre-opening  Existing Roadways  Stage 5 – Operations Review When Can an Audit Be Done?

7. March 2006 Types of Audit Data  Information collected for use in audit  Traffic counts  Public hearing information  Detailed designs  Crash Data

8. March 2006 Types of Audit Data  Information collected from audit report  Prioritized findings and recommendations  Multi-disciplinary report  Comments from special road user groups

9. March 2006  Geographic Representation from across state.  Representation from various disciplines: Traffic Engineering, Planning, Engineering, Construction, Pre Construction, Special Interest groups.  Special Interest groups (ie, local law enforcement, EMS, Disabilities and Special Needs, AARP, etc.) RSA Team Participants

10. March 2006 RSA Follow Up  Conduct follow up study to determine impact on traffic safety 3 years after final audit report.  Examine traffic collision data 3 years before and 3 years after audit.  Include RSA team to assist in evaluation as needed.

11. March 2006

12. Opinion Surveys  Telephone Surveys  Random Digit Dialing  Unbiased  Varied Demographics (Age, Race, Education, Income)  Representative sample of licensed drivers

13. March 2006 Opinion Surveys  Examples of Telephone Surveys  Follow-up evaluation of public information campaigns  Determine public opinion on safety issues Primary Safety Belt Law.08 BAC Motorcycle Helmet Legislation  Determine changes in public opinion on safety issues (Baseline/Ongoing)

14. March 2006 Opinion Surveys Focus Groups  Used for more qualitative information  Used in a wide range of applications in nearly every field of market research.  Encourages participants to express their feelings freely and without inhibitions  Probes more deeply into issues in a relaxed, uncontrolled atmosphere.

15. March 2006 Opinion Surveys Focus Groups  Discussion leaves participants feeling, justifiably, that their opinion is important  Gives clients a clearer perspective on how their customers feel and why they feel that way.  Information gained may lead to changes in program and product development and implementation.  Include demographic representation of target population.

16. March 2006 Opinion Surveys  Used as part of dispute resolution, or to solicit opinions before making significant changes.  Useful in developing consensus when community opinion is not immediately obvious in normal discussion.  Especially useful during legislative debate on controversial safety issues.  Also, useful in developing funding priorities.

17. March 2006 Observational Surveys  Sometimes the best way to collect information about people's behavior is to watch them.  Observation allows the researcher to collect information without being a burden on the person providing the information.  Typically evaluators develop guides that structure the observation process.

18. March 2006 Observational Surveys  Drawbacks:  Measures only what you can see. Other types of data (e.g., opinions, reasons behind behavior) cannot be collected in this fashion.  Time-consuming as multiple observations are often required.  Presence of collectors may influence behavior.  Safety of observers.

19. March 2006 Program Assessments  Help determine ways to improve effectiveness and efficiency of programs.  Provide tools and documentation by which additional steps can be taken to make programs better and/or safer.  Identify gaps in services.  Provide support for additional financial and human resources.

20. March 2006 Program Assessments  Peer reviews of programs. NHTSA currently offers program assessments for the following:  emergency medical services  impaired driving  traffic records  motorcycle safety  occupant protection

21. March 2006  Examples :  Studies on the effectiveness of program activities  Identifies steps to be taken to enhance existing programs  Evaluates the implementation of new programs  Assists in justifying additional funding and program support  Considers current legislation and the direction for legislative action  Provides documentation to be used as National and State input for policy, training and program development. Program Assessments

22. March 2006 How Do You Arrange for a Program Assessment?  The State Highway Safety Offices obtain program assessments by writing and requesting an assessment from one of the NHTSA Regional Offices.  If information or assistance is needed regarding the Highway Safety Program Assessments, please contact the NHTSA Regional office for your state.

23. March 2006 Interviews  Interviews with local agencies personnel (Police, EMS Responders, Local Engineers, Coroners) provide invaluable data.  Insight on perceived needs (more enforcement, engineering improvements, etc.)  Opportunity to speak with someone that may have been first on the scene at a particular incident or fatality  The benefit in some cases of a play by play account of what happened at a particular crash

24. March 2006 Interviews  Provide insight on local uses for roads (cut through, alternate route to avoid traffic, racing, truck route, etc.)  Offer insight as to how areas surrounding road may change with the various seasons  Is there anything planted that might impede sight distance at an intersection?  Are there any streams that deer gravitate toward which might increase the need for them to cross roads?  Become aware of planned projects that may impact the road

25. March 2006 Interviews  When do you conduct interviews?  Site visits  Monitoring visits  Roundtable discussions  Development meetings  Public Hearings / Town Hall Meetings  Annual Professional Conferences  Individual Interviews

26. March 2006 Interviews  Questions asked in interviews  What is the most common type of crashes?  What happens when it rains? Does the road flood in particular area?  Did something change in the landscape recently that might affect why crashes increased (i.e., cutting down trees that block the sun)?

27. March 2006 Safety Conscious Planning “...a proactive approach for the prevention of motor vehicle crashes and unsafe transportation conditions.” Improving Safety on Our Highways

28. March 2006 Safety Conscious Planning... a comprehensive, system wide, multi-modal, proactive process that better integrates safety into surface transportation decision making.

29. March 2006  Considers all aspects of highway safety – engineering, education, awareness, enforcement & emergency response  Uses a system-wide approach including sites, corridors & entire state, regional & local transportation systems Safety Conscious Planning

30. March 2006 Safety Conscious Planning  Multi-modal including transit, pedestrian & bicycle safety needs  Proactive - addresses current safety problems & looks for opportunities to prevent them in the future

31. March 2006 Forum Participants  Broad cross section of planning and safety communities  Statewide representation  Multidisciplinary group (including MPO’s, COG’s)  Federal partners (FHWA, NHTSA, FMCSA)

32. March 2006 Plans Provided to Participants  AASHTO Strategic Highway Safety Plan  Emergency Medical Services State Plan  Federal Railroad Administration Action Plan  402 Highway Safety Plan  Injury Control Plan  SCDOT Strategic Plan  SC Long Range Transportation Plan  Others

33. March 2006 Data Guide  SCDOT (Road Inventory, Traffic Counts, Mileage Reports)  SCDPS (Collision File)  SCDMV (Driver & Vehicle Files)  EMS (Run Reports, Trauma Registry)  DAODAS (School Age & Adult Surveys)  Office of Research & Statistics (CODES, Census, Hospital Discharge)

34. March 2006 Forum Accomplishments  Brought over 200 partners together, many 1 st time  Adopted several goals & strategies to improve safety – all willing to support in their plan  Improved communications among partners (E- mail group)  Enlightened participants on available data sources

35. March 2006 CODES Project  Crash Outcome Data Evaluation System  Multi-agency effort which includes:  SC Department of Public Safety  SC Department of Transportation  SC Department of Health and Environmental Control  SC Emergency Medical Services  SC Budget and Control Board Office of Research and Statistics

36. March 2006 CODES: Goal Provide a comprehensive view of motor vehicle crashes and their resultant impact on morbidity, mortality, health care services and associated costs.

37. March 2006 CODES Project  Collaborative approach to obtain medical and financial outcome information related to motor vehicle crashes for highway safety and injury control decision making.  Evolved as the result of the Intermodal Surface Transportation Efficiency Act (ISTEA) of 1991  Report to Congress about the benefits of safety belts and motorcycle helmets for persons involved in motor vehicle crashes.

38. March 2006 CODES Project  Measure benefits in terms of reducing death, disability, and medical costs  Includes statewide data for all persons involved in police- reported crashes  Includes those who were injured or who died as well as those who were not injured.  Allows comparisons between those using and not using safety belts or motorcycle helmets  Identifies and contrasts characteristics of injured and uninjured persons within each of the restraint use groups.

39. March 2006 CODES: Linked Data Sets  Crash (DPS)  Emergency Medical Services (DHEC EMS)*  Hospital (ORS) *Prior to 2001 only

40. March 2006 Data Collected: Crash  Demographic Data  Driver / Pedestrian / Pedalcyclist  Passengers  Restraint Usage  Crash Location / Type of Crash  Contributing Factors  Injuries / Fatalities / Transported  Alcohol or Drug Involvement

41. March 2006 Health Care Utilization Databases  Hospital Inpatient Discharges  Ambulatory Surgery Episodes  Emergency Room Visits

42. March 2006  ABOUT THE PATIENT: age, race, gender, geographic location codes  ABOUT THE EPISODE: Hospital & Physician Characteristics  primary diagnosis and nine related diagnoses  primary and nine secondary procedures with dates, admission and discharge dates, length of episode  destination at discharge (home, home health referral, death, etc.) Data Collected: Health Care Utilization Databases

43. March 2006 Data Collected: Health Care Utilization Databases  COST OF CARE:  Detailed charges by revenue center (e.g., pharmacy, lab, respiratory therapy, etc.)  Primary and secondary payer class (e.g., Medicare, Medicaid, Private Insurance, Self-pay/Indigent) * Hospital charges used as proxy

44. March 2006 CODES Project  Links databases containing information about individual persons collected from police crash reports, emergency medical transports, emergency room visits and inpatient hospitalization records.  Uses probabilistic linkage methods  SC has been a CODES state for 7 years.

45. March 2006 CODES Project  System helps in analyzing crash patterns.  Includes a mapping system to locate crashes based on such characteristics as crash severity, volume of crashes, age of driver and involvement of alcohol and/or drugs.  Developed CODES Internet site to facilitate the dissemination of information from the project.

46. March 2006 CODES Project  Statewide data collected on all persons:  Involved in police-reported crashes  Transported by emergency medical services due to crashes  Visits to emergency room due to injuries  Hospitalized due to injuries.  Analyses of data used to measure impact of crashes by communities in terms of reducing injuries, deaths, and medical costs.  Comparisons can be made between the characteristics of those using and not using safety belts, helmets, and other restraints.  PDO crashes were not included in the linkage or analysis.

47. March 2006 Uses of CODES Data  Provides economic argument for safety legislation  Primary Belt Law .08 .10 Per Se  Automated Enforcement at Red Lights  Develops profiles for Safe Communities Programs  Provides demographic data to develop educational / enforcement programs.

48. March 2006 Impact of ED Data on CODES  Policy decisions can be made based on better estimates of medical cost data  Population of crash victims injured and treated in a hospital setting more accurate  Surrogate SC Trauma Registry  Complete look at crash and injury patterns for Community Needs Assessments (high volume vs. high injury)

49. March 2006 Data Request / Fact Sheet  Restraint use by pay source and treatment type (ED and inpatient)  Number and rate of injuries  Total and average charges  Length of stay (inpatient only)  Also included the total numbers of injured, number and percent linked from crash to hospital data.

50. March 2006 What is a Data Cube?  While ORS answers requests now using information from the Data Warehouse, our dream was to create a  “WEB-Accessible User-Driven Query Based System that agencies can access and explore their own questions”  Cubes would be for statistical / aggregate analyses

51. March 2006 SC Data Warehouse  Build off of existing systems (legacy systems from state agencies and private sector)  Create a Unique ID (not related to any other number)  Identifiers are pulled off of the statistical data. Use only the statistical data  Data is always “owned” by the originating agency. Must have permissions to use and/or link any data

52. March 2006 Disabilities & Special Needs Vocational Rehabilitation Law Enforcement Health Department Education Outpatient Surgeries State Employee Health Services Emergency Room Visits Hospitalizations Environmental Conditions Home Health Care Medicaid Services Social Services Public Safety Mental Health Juvenile Justice Integrated Data System Free Clinic Visits Alcohol & Drug Services Child Care Community Health Centers* Medicare Legal/Safety Services Social Services Claims Systems All Payer Health Care Databases Behavioral Health Health Department Education Other State Support Agencies LEGEND Disease Registries Elder Services & Assessments *Still in contract negotiations. Probation Parole & Pardon Corrections*

53. March 2006  Data Warehouse Allows Agencies & Other Entities to:  Evaluate their programs  Look at Outcomes  Understand better how their programs interact with other agency & other entity programs  Study Health, Human Service, Education, and Law Enforcement Issues  Analyze Statistical – Aggregate Information  Access Analytic Data Cubes  Partner in the Development of Customized Software Applications SC Data Warehouse

54. March 2006 Disabilities & Special Needs Vocational Rehabilitation Law Enforcement Health Department Education Outpatient Surgeries State Employee Health Services Emergency Room Visits Hospitalizations Environmental Conditions Home Health Care Medicaid Services Social Services Public Safety Mental Health Juvenile Justice Injury and Violence Cube Free Clinic Visits Alcohol & Drug Services Child Care Community Health Centers* Medicare Legal/Safety Services Social Services Claims Systems All Payer Health Care Databases Behavioral Health Health Department Education Other State Support Agencies LEGEND Disease Registries Elder Services & Assessments *Still in contract negotiations. Probation Parole & Pardon Corrections*

55. March 2006 Linking Data Sets  Records are linked for the same individual using a unique tracking number  Tracking number is random so cannot be unencrypted to identify the individual  An individual is assigned the same number over time

56. March 2006 What Is an Analytic Cube?  A way to “slice and dice” through large amounts of data  Define “slicers,” characteristics that are important to analyzing the subject population  Pre-aggregate the linked data by all possible combinations of “slicers”

57. March 2006 Data shown as an example - not for analytical use

58. March 2006 Data shown as an example - not for analytical use

59. March 2006 Data shown as an example - not for analytical use 59

60. March 2006 Data shown as an example - not for analytical use

61. March 2006 Cubes Under Development  Injury Cube (funded through a CDC grant)  Mental Health/Alcohol Cube funded through DMH funds  Medicaid Cube (all ages)  Elderly Cube (just received funding to development this cube!)

62. March 2006 Complaint File  Track all complaints  News stories, editorials, news articles  Be Responsive to public concerns  Is it a real problem or just perceived?  Coordinate site visit  Prepare response  Include in future planning  Compile crash data for complaint site Do not ignore the public!

63. March 2006 Program Evaluation Reports  Assess how well the program has been implemented.  Assess the extent to which the activities have achieved the project’s goals.  Identify gaps in services.  Identify spin-off efforts.

64. March 2006 Establish an Evaluation Plan  How will you know you’re achieving goals?  What will you measure?  How will you evaluate?  Who measures? When?  What documentation will you maintain?  When and what evaluation report?

65. March 2006 Process Evaluation  Why a program succeeds or fails.  Compares program design with implementation.  Describes and documents life of program.

66. March 2006 Outcome Evaluation  Deals with short-term, direct effects of program.  Identifies the results of a program's/initiative's effort.  It seeks to answer the question, "What difference did the program make?“  It provides information about effects of a program after a specified period of operation.

67. March 2006 Impact Evaluation  Deals with long-term, ultimate effects of program.  Assess program effectiveness in terms of end results, including intended and unintended results.  Also assess the net effect of a program by comparing impacts with an estimate of what would have happened in the absence of the program

68. March 2006 Professional Judgment  Allows for a multi-disciplinary approach.  Assimilates data from variety of sources to determine strategies.  Provides benefits from years of knowledge and experience.  Essential to any planning process.

69. March 2006 For More Information Contact: Terecia Wilson Director of Safety 803-737-1161 WilsonTW@scdot.org