When the first reports of the bus crash on I-90 started coming through last fall, everyone expected it was going to be a tough day. On Nov. 18, 2009, at about 3 p.m., a bus full of elderly gamblers from a nearby casino went off the road and tipped over near Austin, Minn. The bus driver lost control when he suffered an aneurysm.
What happened next proved that the vision that created Minnesota’s Toward Zero Deaths (TZD) program was more than just a good idea. A confluence of first responders from three agencies descended on the crash and went to work. Almost 40 state troopers from the Department of Public Safety, just finishing up some training nearby, arrived to help. The Minnesota Department of Transportation (Mn/DOT) then closed I-90, one of the busiest highways in southern Minnesota, in both directions to let helicopters land. Six helicopters as well as seven ambulances and six fire departments from the surrounding area transported the injured. The injured were taken to the nearest two hospitals, and some were then transferred to the nearby Mayo Clinic.
At the end of the day, there were two fatalities from this crash. The rest of the bus passengers (21) were injured and transported to appropriate care centers. The response to this crash was a testament to the cooperation that is at the heart of TZD’s vision, mission and goals.
“We’ve worked hard to create this collaborative, efficient, effective relationship, and when we see it saving lives like this, it makes it all worth it,” said Mark Kinde, the Injury and Violence Prevention Unit Leader at the Department of Health, and a core member of TZD’s leadership team.
Going for zero
TZD is a cooperative, interdisciplinary program led by three state agencies with the assistance of the University of Minnesota’s Center for Transportation Studies:
- Mn/DOT;
- The Minnesota Department of Public Safety; and
- The Minnesota Department of Health.
TZD’s mission is “To create a culture for which traffic fatalities and serious injuries are no longer acceptable through the integrated application of education, engineering, enforcement, and emergency medical and trauma services. These efforts will be driven by data, best practices, and research.”
Instead of just aiming for zero deaths all at once, TZD’s leadership set some realistic milestones along the way. When this program began in 2003, the leaders wanted to reverse the trend of ever-increasing road fatalities (655 that year) and aim for fewer than 500 deaths in 2008. When they reached that goal two years early, TZD set a goal for fewer than 400 deaths in 2010.
“When we were developing the framework for this change, some asked if we were being unrealistic,” Cheri Marti, TZD co-chairperson and director of the Office of Traffic Safety for Minnesota’s Department of Public Safety, said. “But how many deaths are acceptable? The only answer we were comfortable with is zero—every life counts.”
The four E’s
There are four cornerstones to TZD’s approach: education, enforcement, engineering and emergency medical and trauma services. It is easy to see how each agency is represented in each of the E’s, and education is the overarching principle that everyone owns.
Engineering
When TZD began in 2003, Mn/DOT shifted its approach to safety in three significant ways:
3. Choosing infrastructure tactics that were proactive, low-cost and systematic. Fatal crashes in rural areas are not clustered around one location. However, the types of crashes are similar (e.g., run-off-the-road and intersection related). Addressing these types of crashes, which can occur at random locations, requires low-cost solutions that can be deployed systematically along miles and miles of roadway. Rumble strips and intersection lighting are two good examples of proactive, low-cost, systematic strategies.
One of the most successful engineering solutions has been installing cable-median barriers. With 229 miles currently in place, these barriers have reduced cross-median fatalities to zero on those roads where they have been installed. In fact, Mn/DOT’s State Safety Engineer Dave Engstrom got a call from one woman who wanted to thank him for saving her life. She was passing a truck, lost control and just saw headlights coming at her. She thought she was a goner.
“The cable median barrier did exactly what it was designed to do,” said Engstrom, “and she walked away from the crash.”
Education
Education comes in many forms. Sometimes it takes the shape of a state trooper talking to a class full of young people. Sometimes it is a public service announcement about drinking and driving. Sometimes it is an engineer talking to county commissioners about low-cost safety improvements to rural roads.
One particularly successful educational program centers on the “How to Save a Life” video. Developed by the Department of Public Safety, the video tells the stories of those who are left behind when young people are killed in traffic crashes: their family, their friends and the troopers who deliver the bad news. It is always shown with a trooper in the room who is there to field students’ questions. “How to Save a Life” has been shown to 30,000 students in Minnesota.
Wright County’s Safe Communities, a local organization aligned with TZD and located in central Minnesota, is another example of innovative educational thinking. Driver’s education classes in Wright County have a new requirement: Parents and their kids have to attend a 90-minute presentation from emergency medical professionals. The presentations include crash photos from their county. Most parents (91%) report that this has changed the way they teach their children to drive.
Enforcement
When enforcement is coupled with education you see real behavior change. Minnesota’s Driving Under the Influence Zones are a good example of both aggressive and highly visible enforcement. It begins with an extensive publicity campaign to let the public know that enforcement efforts will be stepped up and where the troopers will be focusing. Then portable electronic message boards are set up in the area to let drivers know they are entering an enforcement zone. Even with all the warnings, there are still arrests for driving under the influence (DUI) during these periods.
More importantly, these zones have increased the perceived risk of an arrest (from 36% to 51%) for DUI in those counties where it was tried. The state is currently running DUI zones in the 13 deadliest counties in Minnesota.
“Enforcement is just one of many important aspects of traffic safety,” Col. Mark Dunaski, State Patrol chief and a core member of TZD’s leadership team, said. “Education, engineering and the EMS system working with enforcement is far more effective than any one discipline standing alone.
” Another enforcement measure is HEAT (High Enforcement of Aggressive Traffic), a cooperative effort of the departments of Public Safety and Transportation. Since 2006 the Minnesota State Patrol has been running HEAT, which targets speeders and drivers who tailgate. Using Mn/DOT’s speed, crash and mapping data, HEAT zones are established based on where speed-related fatal and serious injury crashes are occurring. More recently, the program has expanded to include patroling of county roads along with state highways and interstates. Two officers on a county road were recently approached by a local farmer. He told them he had been complaining about the speeds on that road for 30 years, and thanked each of them with a candy bar.
Another key element of changing driver behavior is the enforcement of good traffic safety laws. Many stakeholders have worked with legislators to pass a series of laws that will help police make the roads safer. These include:
- Legal limit for impaired driving of .08 blood-alcohol content—2005;
- Statewide trauma system established—2005;
- Graduated driver’s license with passenger and nighttime restrictions—2008;
- No texting while driving—2008;
- Booster seat law strengthened—2009; and
- Primary seatbelt legislation—2009.
Once a crash occurs and drivers are injured, the emergency medical and trauma service kicks into gear. These professionals get to the scene, triage the situation and transport the victims to the nearest appropriate medical facility.
Since trauma is the single most common cause of death, it is important to have medical professionals trained in trauma response working on these victims. Minnesota has been working to create certified trauma centers around the state and currently has 104 hospitals that are designated, or in the process of being certified, as trauma centers. It is estimated that having this system of trauma centers has reduced traffic fatalities by 9%.
Timely care after an injury is the most important predictor of survival, but appropriate care also is critical. That is why the Department of Health, in addition to creating the network of trauma centers, has worked hard to create specialized trauma centers certified by the American College of Surgeons. This is the highest level of certification and requires medical centers to meet extensive, strenuous standards. Minnesota has two Level 1 pediatric trauma centers and four Level 1 trauma centers. That means more people can get the right treatment fast, and that saves lives.
The TZD network
The network of connections, collaborative relationships and cooperative teams make TZD work. That is what helped the organization turn the corner back in 2003, and it continues to be the critical element as it pushes the numbers of fatalities down every year
In addition to all the community and countywide efforts being made across the state, TZD sponsors quarterly stakeholder breakfasts, two regional conferences and one annual conference. Attendance at last October’s annual conference topped 600, very close to the estimated number of lives (655) that have been saved on Minnesota’s roads since TZD began.
When TZD began, something had to be done to make Minnesota’s roadways safer. Partners like county engineers, county commissioners, local law enforcement, AAA, community safety coalitions and local emergency services professionals have embraced this philosophy and, together, have begun to change the traffic safety culture in Minnesota.
