Signal Cleveland’s analysis of trauma needs in Northeast Ohio is an effort to update a similar analysis published in 2019.
The 2019 analysis was conducted under a research grant for Ohio’s division of Emergency Medical Services.
Here is more information about the methods and data we used.
Data sources
The 2019 assessment used census data, Ohio’s trauma registry and a map of state-designated trauma centers on the Ohio EMS website.
Signal Cleveland used the same sources. To calculate populations, Signal Cleveland used the U.S. Census American Community Survey’s one-year estimates.
To determine how many trauma centers exist in the region, Signal Cleveland used the Ohio Designated Trauma Centers map on Ohio’s EMS Website.
The rest of the data points relied on numbers from Ohio’s trauma registry, which is kept by the state’s Department of Public Safety. The department provided the numbers shared in the study pursuant to Signal Cleveland’s requests, including:
- How many severely injured patients were discharged alive in the region from non-trauma centers, i.e. acute care and critical access facilities
- How many severely injured patients were seen in trauma centers in the region. The department provided county-by-county data, which Signal Cleveland added up.
Signal Cleveland requested data on median transport time from the state’s Department of Public Safety. Spokespeople for the department told Signal Cleveland that the information would require significant reprogramming from existing databases, which would force the department to create a new record, which it is not required to do under public records law.
Signal Cleveland instead accessed the number by asking several state lawmakers to make the same request to the state’s Department of Public Safety. The department calculated the median transport time for the lawmakers using data kept in the trauma registry that tracks the time ambulances left a scene to the time they arrived at the hospital.
Year of analysis
The majority of the information collected is from 2024. That includes census data and trauma registry data.
This is because 2024 is the latest year with reliable data available from the U.S. Census American Community Survey’s one-year population estimate for counties. Signal Cleveland used 2024 data for all information and data about traumatic injuries because Ohio’s trauma registry data for 2025 was labeled preliminary.
The only information that did not come from 2024 was about which state-designated trauma centers exist. Signal Cleveland used information collected in 2026 from a map of designated trauma centers on Ohio’s EMS Website. This is similar to the 2019 analysis, which collected the data on which trauma centers exist in October 2018 while the rest of the data came from 2017.
Based on press releases and annual trauma reports published by the state’s Department of Public Safety, no new trauma centers were added in Northeast Ohio between 2024 and 2026. One trauma center was removed, however. MetroHealth’s Parma hospital ceased to be a Level III trauma center in August 2025.
Severe injury definition
Several data points in Signal Cleveland’s analysis refer to “severe injuries.” Severe injuries are defined as those with injury severity scores – scores determined by medical providers – of above 15.
On patients discharged from non-trauma centers
One data point in the analysis looked at how many severely injured patients were discharged from non-trauma centers. This is meant to measure how many patients who needed higher-level trauma care did not receive it.
Signal Cleveland included the number of patients who were discharged alive, as this appeared to be the same method used in the 2019 analysis. The original NBATS methodology simply requests researchers look at those discharged from non-trauma centers.
Other researchers who have completed NBATS assessments also included in this measure the number of severely injured patients who died in non-trauma centers. This group of people is not accounted for in Signal Cleveland’s analysis.
