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6 2 Overview The goal of the NCHRP project 17-57 is to develop a comprehensive roadmap that guides states along the path to measuring the number of serious injuries in crashes. This goal has been motivated by the Moving Ahead for Progress in the 21st Century Act (MAP-21), which requires a set of highway safety performance metrics that includes assessment of serious injuries in crashes. This report is a comprehensive description of the findings and recommendations from the first three tasks of the NCHRP 17-57 project. Although MAP-21 requires measurement of serious injury, it does not define it. The first task in this project was to recommend a definition of serious injury. As will be explained in the first section, we recommend a medical-diagnosis- based definition of serious injury for use by states. Choosing a medical-diagnosis-based definition, rather than a police report-based definition, represents a critical point in the entire process of developing state data systems to record serious injury in crashes. If this choice is accepted, as we strongly recommend, then it requires some means of working with medical outcome data. If such analysis is to go beyond simple counts and allow serious injury to be tied to crash, roadway, behavior, vehicle, and occupant characteristics, then linking medical outcome data to crash data is required. The remainder of the project was devoted to exploring options and developing a roadmap for states to achieve this goal (comprehensive linkage of datasets, including crash and medical outcome). Within the project, there were several tasks designed to gather the necessary information to develop the roadmap. These tasks are listed in Table 1 as they were originally envisioned. Table 1. Tasks included in NCHRP 17-57 Task Task Name 1 Outcome identification and short-term solutions. 1a Perform a literature review to select an injury severity metric based on hospital data. 1b Analysis and modeling of injury data to develop a near-term method for improved injury severity coding. 2 Roadmap(s) to interim solutions for direct linking crash and hospital data. 2a Identify best practices for development of crash-EMS-hospital linkage through case studies of states currently performing linking and states working toward linking. 2b Review strategic highway safety plans and survey state data holders to identify existing procedures and potential barriers to crash/hospital data linkage. 2c Develop draft roadmap(s) for linking crash, EMS, and hospital data. Solicit feedback from states on these roadmaps. Refine roadmaps based on feedback. 3 Refine roadmap to include methods for linking to other relevant state datasets. Solicit feedback from states on these roadmaps. Refine roadmaps based on feedback.
