PROBLEM IDENTIFICATION
In the six states served by the National Highway Traffic Safety Administration's (NHTSA) Region 8 office, motor vehicle crashes result in 1,600 deaths each year and are the leading cause of injury and death among persons between the ages of 1 and 34 years. The states and communities that comprise Region 8 historically have attempted to address this problem using tools adapted from successful efforts undertaken in other communities. However, few communities are able to sustain a decrease in injury and fatality rates.

GOALS AND OBJECTIVES
The goal of the Continuous Quality Improvement (CQI) Technical Assistance program was the reduction of roadway-related injuries and fatalities within Region 8. Objectives of the CQI Technical Assistance program were designed to:

• Help community traffic safety program planners "break out of the box" when implementing programs
• Using the Safe Communities program as a vehicle, provide safety personnel with the leadership skills necessary for creating a safe community
• Help safety planners learn and fine tune technical skills that lead to immediate success in a Safe Communities program
• Provide community safety planners with the tools to deliver leadership presentations within their Safe Communities programs

STRATEGIES AND ACTIVITIES
Program planners from the NHTSA Region 8 office joined with the Federal Highway Administration (FHWA), the American Society for Quality, and the Institute for Healthcare Improvement to adapt a new methodology (Continuous Quality Improvement) for implementing traffic safety programs that affect long-term behaviors and promote sustained results from these programs. The methodology was then presented, via an interactive videoconference, to community safety program leaders, law enforcement officials, child safety seat specialists, state highway safety staff, FHWA division and regional staff, and NHTSA staff in the capital city of each state in Region 8. The teleconference, "Reducing Injuries and Fatalities — Combating an Epidemic Within a Safe Community Environment," was held in March 1998, and demonstrated the new Continuous Quality Improvement management methods within the framework of the Safe Communities program, using a three-pronged training approach:

• The first "prong" of the training provided teleconference facilitators from the American Society for Quality to demonstrate the CQI process using an interactive adult learning method, the Plan-Do-Check-Act (PDCA) technique, to practice the use of key factors that have previously contributed to the successful use of CQI for implementation of traffic safety programs
• Prong two involved a demonstration by a Safe Communities program director from North Dakota on how to apply the CQI process to Safe Communities opportunities
• To complete the approach, a NHTSA Safety Belt and Child Safety Seat program specialist provided instruction on occupant protection technology, illustrating the ease with which a program can be implemented at the community level using the techniques learned in the training