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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.

APPENDIX A

Survey Questionnaire

Email to Potential Participants

From: Gabriel B. Dadi, Ph.D., PE
To: Members of the North American Association of Transportation Safety & Health Officials (NAATSHO)
Subject: NCHRP Project 20-05/Synthesis Topic 55-15: Safety Leading Indicators – Survey Request

Dear Department of Transportation Representative,

The Transportation Research Board (TRB), through the National Cooperative Highway Research Program (NCHRP), under the sponsorship of the American Association of State Highway and Transportation Officials (AASHTO), and in cooperation with the Federal Highway Administration (FHWA) is preparing a synthesis report on Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance.

The purpose of this questionnaire is to identify DOT use, frequency, and perceptions of safety leading indicators to improve employee safety performance. The results of the survey will be incorporated into a synthesis of highway practice, with the intent of helping DOTs evaluate and improve their safety management practices.

This survey is being sent to each DOT for distribution to applicable employees. If you are not the appropriate person at your agency to complete this questionnaire, please forward this request to the correct person (see attached questionnaire for an idea of the questions asked). DOT survey responses will be shown in the published synthesis report. However, the identity of survey respondents will remain anonymous.

Please compete and submit this survey by Friday January 19th. We estimate that it should take no more than 20 minutes to complete. If you have any questions or problems with operation or access to the questionnaire, please contact me, the project principal investigator, Dr. Gabe Dadi.

Thank you for your time and expertise in completing this questionnaire.

Survey Link

NCHRP Project 20-05/Topic 55-15 Safety Leading Indicators SURVEY LINK

Best,

Gabriel B. Dadi, Ph.D., PE

W.L. Raymond and R.E. Shaver Chair Associate Professor

Department of Civil Engineering

University of Kentucky

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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.

Demographic Information

(Reminder your name will not be published, but responses will be made available in Appendix B of the final report)

  1. Name:
  2. Title:
  3. Email:
  4. Phone Number:
  5. Select the responding Department of Transportation (DOT) (Note to panel: this will be a drop-down list)

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

District of Columbia

Florida

Georgia

Hawaii

Idaho

Illinois

Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Missouri

Montana

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Carolina

North Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

Rhode Island

South Carolina

South Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West Virginia

Wisconsin

Wyoming

  1. What office is responsible for managing employee/occupational safety at the DOT?

Human Resources Employee/Occupational Safety Management/Finance Other ________

  1. Please select the most appropriate descriptors of the DOT.

Employees Staffed (Check all that apply): Permanent Temporary Consultant/CEI

Non-Management Staff Labor Representation: Union Non-Union Both

Non-Management Staff Hiring System: Civil Service/Hired Non-Civil Service/Appointed Both

Human Resource Type: HR within the DOT HR as a statewide agency Both

DOT Governance: Centralized DOT Semi-centralized DOT De-centralized DOT

OSHA Report Required: State Plan OSHA Federal Plan OSHA Both Neither (for public employees)

Definition of Safety Leading Indicators

For the purposes of this survey, safety leading indicators are “proactive and preventive measures that can shed light about the effectiveness of safety and health activities and reveal potential problems in a

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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.

safety and health program (OSHA)”. These would be in opposition to lagging indicators that are safety measures after an incident occurs such as a total recordable incidence rate (TRIR) and days away, restricted, or job transfer (DART).

When asked about documenting, using, or tracking of safety leading indicators, this means the measure(s) are documented regardless if on paper, through electronic means, or through a safety management system (SMS).

Safety Leading Indicator Use

  1. Does the DOT document safety leading indicators?

Yes No (if selected, skip to Q30)

  1. How long has the DOT documented safety leading indicators?

Less than a year 1 - < 3 years 3 - < 5 years 5 - < 10 years More than 10 years

  1. Of the following safety leading indicators, which does the DOT document and how frequently are they documented, used, or tracked?
Types of safety leading indicators Is Documented As needed Daily/Weekly Monthly Quarterly Annually Other
Reporting of Near-Miss/Close Call
Use of Safety Committees
Supervisors Being Coached and Encouraged for Safety
Employee Perceptions of Just and Fair Safety Culture
Safety Leadership Training
Use of Toolbox Talks
Use of Safety Audits/Risk Assessments
WorkZone Traffic Control Training
First Aid/CPR Training
Use of Stretch and Flex Programs
Use of Wellness Programs
OSHA 10 Training
Communication of Safety Lessons Learned
Reporting of Vehicle Inspections
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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
Reporting of Vehicle Operations
Participation and Buy-In of Leadership to Safety Activities
Existence of Agency Safety Champion
Tracking PPE Spending/Replacement
Investing in Safety Programs
Tracking Safety Training Logs
Other
  1. Which of the following training programs are included for the DOT’s safety training program? Select all that apply.

Safety Leadership OSHA10 OSHA30 WorkZone Traffic Control First Aid/CPR Defensive Driving Other

  1. Which safety training programs does the DOT’s leadership participate in? Select all that apply.

Safety Leadership OSHA10 OSHA30 WorkZone Traffic Control First Aid/CPR Defensive Driving Other

  1. For the DOT’s safety training program, how are they delivered? Select all that apply.

Live, In-person

Synchronous (live), Virtual

Asynchronous, on-demand Virtual

Other

  1. Does the tracking and reporting requirements of safety leading indicators flow through to private contractors/consultants/CEI?

Yes, it is written in their contracts Yes, but it is not formally written in their contract No

Implementation and Results

  1. What method(s) does the DOT use to capture and document your safety leading indicators? Select all that apply.

Collected on paper and stored on paper

Collected on paper and stored electronically (e.g., scanned PDFs or data entered into a spreadsheet)

Collected through electronic safety management system (SMS)

Other

  1. How does the DOT use the data you capture from safety leading indicators? Select all that apply.

Visualize current state (i.e., through a dashboard)

Short-term changes (i.e., quarter to quarter changes)

Long-term changes (i.e., year to year changes)

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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.

Correlate leading indicators to lagging indicators (i.e., using the leading indicators to explain the DOT’s Total Recordable Incidence Rate (TRIR), Days Away, Restricted, or Transferred Rate (DART), Workers’ Comp Claims)

Other

Data is used as needed/requested

  1. Is the safety leading indicator data that the DOT collects analyzed to be used for improvements to the employee safety program (e.g., develop policy changes, invest in new safety equipment or technologies, etc.)?

Yes No Unsure

  1. Does the DOT communicate roles, responsibilities, and expectations for the following positions in regard to their participation in the documentation of safety leading indicators? Select all that apply.

Maintenance crews

Superintendents

District/region engineers

District/region safety managers

District/region leadership

Central office safety managers

Central office executive leadership

Other

No roles, responsibilities, or expectations are communicated

  1. Who uses the data that is documented from the safety leading indicators? Select all that apply.

Maintenance crews

Superintendents

District/region engineers

District/region safety managers

District/region leadership

Central office safety managers

Central office executive leadership

Other

Data is used as needed/requested

  1. What strategies has the DOT implemented to develop a safety leading indicators program? Select all that apply.

Formation of oversight team

Communication plans/advertisement of program

Included in collective bargaining agreement

Pilot the safety leading indicator program in region or district

Employee suggestion or other feedback mechanism

Dedicated staff to managing the program

Other

No implementation strategies have been used

  1. Has the DOT found any of the following implementation strategies to be successful?

Formation of oversight team

Communication plans/advertisement of program

Included in collective bargaining agreement

Pilot program in region or district

Employee suggestion or other feedback mechanism

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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.

Dedicated staff to managing the program

Other

  1. Does the DOT use any of the following incentives or disincentives within the safety leading indicator program? Select all that apply.

Financial rewards (i.e., bonuses, gift cards, additional paid-time off, etc.)

Prizes (e.g. plaques, trophies, apparel, meals, etc.)

Positive recognition from leadership (e.g., formally through newsletter highlights, award ceremonies or similar, or informal accolades verbally or at staff meetings, etc.)

Corrective actions (e.g., warnings, negative performance reviews imperiling pay increases, furloughs/suspensions, etc.)

Other

No incentives or disincentives are in current use

  1. What challenges has the DOT experienced with implementing a safety leading indicators program? Select all that apply.

Lack of funding

Lack of staffing support for program

Lack of employee buy-in/participation

Declining safety program momentum

Other duties/programs have higher priority

Lack of identified benefit

Poor morale

Other

No challenges have been experienced

  1. What benefits has the DOT realized since implementing the documentation of safety leading indicators?

Reduction in incident rates

Reduction in worker’s compensation claims

Increased employee engagement in safety

Improved morale around safety

Increased awareness of safety activities

Improved data for safety related decision-making

Other

No benefits have been realized

Written Policies and Procedures

  1. Does the DOT safety leading indicator program have written policies and procedures?

Yes No

  1. (If yes to Q28) Please upload or share link to the written policies and/or procedures relating to the safety leading indicator program.

Questions for DOTs that do not document leading indicators (i.e., responded “No” to Q10)

  1. Does the DOT have plans to document leading indicators?

Yes, within the next 2 years

Yes, within the next 5 years

Discussions are active

No current plans

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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
  1. What barriers exist to documenting a safety leading indicators program?

Lack of funding

Lack of staffing support for program

Lack of employee buy-in/participation

Declining program momentum

Other duties/program have higher priority

Lack of identified benefit

Poor morale

Other

No barriers exist

  1. From the following list, please select the practice of these safety leading indicators that the DOT would like to document.
Reporting of Near Miss/Close Call Using of Safety Audits/Risk Assessments Communicating of Safety Lessons Learned
Using of Safety Committees Providing WorkZone Traffic Control Training Reporting of Vehicle Inspections
Coaching and Encouragement of Supervisors to Promote Safety Providing First Aid/CPR Training Reporting of Vehicle Operations
Creating of Just and Fair Safety Culture Using of Stretch and Flex Programs Participation and Buy-In of Leadership to Safety Activities
Conducting Safety Leadership Training Using of Wellness Programs Existence of an Agency Safety Champion
Using Toolbox Talks Providing OSHA 10 Training Tracking PPE Spending/Replacement
Investing in Safety Programs Tracking Safety Training Logs Other

The survey is complete. Thank you for your participation! This research project’s information can be found at the following link. The final publication will be posted there when available.

NCHRP Synthesis 20-05/55-15

Page 64
Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
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Suggested Citation: "Appendix A: Survey Questionnaire." National Academies of Sciences, Engineering, and Medicine. 2025. Tracking Safety Leading Indicators to Improve DOT Employee Safety Performance. Washington, DC: The National Academies Press. doi: 10.17226/28599.
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Next Chapter: Appendix B: Survey Results
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