A Guide to Starting & Operating an Initial Emergency Care & AED Training and Consulting Business Produced by the AED Instructor Foundation “Helping those who help save lives” Table of Contents Introduction The Key to Success In Business Your Business Profile Establish an Identity for your Business Write Your Mission Statement Create a Business Plan Choose a Legal Structure Consider Your Financing Options Determine Your Products and Services Initial Emergency Medical Care Training Programs Other Health & Safety Training Offerings Sales of Patient Equipment & Material Planning & Consulting Services Setting Up THE LOGISTICS OF Your Business “Work /Storage” Space and Location Mailing Address Clerical Support Suppliers Office Equipment Online Communications/Internet Service Provider and Email Audiovisual Presentations/Materials Audiovisual Projection Equipment Patient Care Training Aids/Materials Books and Printed Materials Insurance Financial Management Setting Fees for Service and Price Lists Banking Services Working Capital/Lines of Credit Debt/Payables Payroll Bookkeeping Financial Projections Support Services & Resources Personnel and Staff Professional Development Sales and Marketing Networking/”Word of Mouth” Telemarketing Distributing Printed Materials Advertising Website – Yours and Other’s Public & Community Events Strategic Alliances Persistence AED Implementation Issues CONCLUSION 3 4 4 4 5 5 5 6 7 7 9 9 10 12 12 12 12 12 13 13 14 14 15 15 16 16 16 17 17 18 18 19 19 19 21 22 25 26 26 26 27 27 27 27 27 29 APPENDIX I: Suggested Equipment List for a Health/Safety Training Agency APPENDIX II: Checklist for Establishing Your Business 30 31 AED Instructor Foundation. All rights reserved. 2002. 2 Starting & Operating an Initial Emergency Care & AED Training and Consulting Business Introduction It is the goal of the AED Instructor Foundation to assist and support initial emergency care instructors in their critical function of preparing first responders in workplaces and public settings to provide a reasonable, appropriate and effective emergency medical response to life threatening medical emergencies. The availability of simple, highly effective and relatively inexpensive Automated External Defibrillator (AED) technology is creating a growing awareness of and interest in initial emergency medical care. This, in turn, is sparking a growing need for AED training and implementation services throughout each community. Most workplaces and public locations have a responsibility and the desire to provide reasonable and appropriate initial emergency care for victims of serious injury and illness, including sudden cardiac arrest. This on-site readiness for all types of perceived illness or injury emergencies requires the services of qualified professionals who provide the planning, training and on-going support that help achieve optimal emergency medical preparedness. Generally, qualified individuals functioning in one of three ways are attempting to meet this need in their communities: as part of a public service/safety/health organization (whether paid or volunteer); in a corporate health and safety training department; or as an independent entrepreneur. The Key To Success In Business: Find A Need and Meet It! This latter methodology has spawned the creation of many private emergency care training and consulting businesses. This new and exciting business prospect is attracting trained and qualified emergency care instructors who wish to own and operate their own enterprise as they pursue their professional aspiration to be of service to others and to help reduce premature death. As one of the AED Instructor Foundation’s many services, Starting & Operating an Initial Emergency Care & AED Training and Consulting Business was created to assist those who choose to use the small business model as a way to help meet the important community need of AED and PAD program implementation. This guide provides a general overview of the considerations and actions essential to establishing, growing and maintaining a successful training and consulting business. The guide is by no means the only business development tool that will be needed; but we believe it will be a useful “primer” for getting started or a good reference for those who have already established their enterprise. It is based on generally accepted small business practices and the experience of several seasoned and successful emergency care training ventures. Many people think that a business degree is needed to start and maintain a training and consulting business. That’s not true. What is needed are basic teaching credentials, ability and instructional materials good “people skills”, the desire to help other people, the willingness to work hard to succeed, and clients/customers who need, want and will pay for your products and services. Many new entrepreneurs are starting businesses as a sideline venture, earning extra income or experimenting with being self-employed. Others do it as full-time employment. Whatever your motivation, this guide was created to help you get started! AED Instructor Foundation. All rights reserved. 2002. 3 Your Business Profile If you are considering opening your own training and consulting company, you will need to think about your business profile. Below are a few things that you must consider. Each component is described in the following pages. • Establish an identity for your business. • Write your mission statement. • Create a business plan. • Choose a legal structure. • Consider your financing options. • Determine the products and services you provide to clients, such as training programs and selling of patient care equipment and materials. • Establish the logistics of running a business, such as office location, training equipment and materials. • Sales and marketing — get the word out about your business. Establish an Identity for your Business Emergency care training, like any other business, begins with the formation of a new identity that has uniqueness and character of its own. You will want to establish a company name that clearly shows what services you and/or your company provides to your specific market. In other words, who and what are you? What will be your business name? An important part of creating a business identity is creation of a company name. Ideally, a company name is representative of its offerings, the nature of the work, and at the same time memorable enough for people to remember it when necessary. Company names in the emergency care training industry range from personal (John Jones & Associates), to descriptive (Health and Safety Services, Emergency First Care, & CPR Professionals) to humorous (Dummies On The Run, Have Dummy – Will Travel). Use caution in using a company name with “Life” in it – it may make differentiating yourself from the competition difficult. There are many training centers with the word “Life” in the title (such as “Life Beat” or “Lifeline”). (Go to your favorite web search engine and type in “AED Training” or “CPR Training” and you will see literally hundreds of sites and names of existing training companies.) The hope of an Emergency Care Training and Consulting Specialist is to evolve his/her company to a point where people associate it with capable and professional emergency care training, planning and products. The first step, however, is to make certain that your new identity for your business tells your future clients who you are and what you do so they make that association. You will need to think about where you want to locate your new business. Many new entrepreneurs run a home-based business or rent a small space in a favorable location. Either way, you will need to check the zoning requirements in your town or city for starting a new business. You will also need to consider any special licenses or permits that you may need related to your profession or to the state and city regulations where you establish your business. AED Instructor Foundation. All rights reserved. 2002. 4 Write Your Mission Statement The mission statement is a company’s statement of its purpose and goals. It tells the world your objectives for your business. Mission statements need to be succinct and clearly written. You should be able to state your mission in a few sentences. Here’s an example of a training company’s mission statement: “ABC Co., headquartered in the Anytown, Ohio, is a private company dedicated to the creation of a safe and healthy workplace for large and small corporations, regional businesses and local governments. We focus on emergency medical preparedness for and proper initial response to serious illness or injury emergencies - including sudden cardiac arrest - that may occur at these locations. We are also provide workplace and public access defibrillation programs.” This statement identifies the purpose of the company (“…creation of a safe and healthy workplace”), the markets that it services (“…large corporations, regional businesses, and local governments…”), and the services that it offers (…preparedness for and proper initial response to medical emergencies ……workplace and public access defibrillation programs…). When you create a mission statement for your company, consider your clientele and what you can offer then. Consider, too, any niche markets you would like to develop as your company grows. Create a Business Plan To create a successful business, consider writing a business plan. A business plan tells you and others (your tax advisor, lawyer, or financial advisors of investors) what you plan to do and how you plan going to go about it. It also helps you to think ahead. Where will your business be in six months? A year? The mission statement clarifies what you do; the business plan explains how you will go about carrying out your mission including a detailed description of your products and services you will deliver; how you plan to notify and attract prospective customers; and how you will organize your efforts to do so. If you are uncertain about how to write a business plan, many community colleges and adult education centers provide short courses on the basics of this particular type of business writing and planning. There are also a number of software programs designed to guide you through this process. Choose a Legal Structure You will need to choose a legal status for your company. This is the official structure of your organization, which will determine how you pay taxes, how you pay yourself, and also how much administration is required to keep your financial and legal records. The simplest form of legal structure is a sole proprietorship. Think of this legal structure as the business activities of an individual person. A business owner registers a business name that is personally linked to him or her. They transact business under the business name and business revenues and expenses are considered extensions of their personal assets. The advantages of sole proprietorship are the relatively simple administration required and the ability to freely float monies from business to personal use. The greatest disadvantage of a sole proprietorship is that the owner is generally personally responsible for the activities of the company. This means that if the company accrues debts or gets sued, it is possible that you, the sole proprietorship, could be burdened with legal and financial responsibilities. If two or more individuals want official ownership of the company, a partnership may be another option. This is another relatively simple business structure in AED Instructor Foundation. All rights reserved. 2002. 5 which business ownership is shared among parties, while at the same time keeping some of the flexibility in moving assets that is enjoyed in a sole proprietorship. The partnership has more or less the same disadvantages as the sole proprietorship. Incorporating is a good option for a training center with more resources. By forming a corporation, the company becomes a separate entity from the owner. This may reduce the owner’s personal liability to some extent. The disadvantage to incorporation is that financial transactions between the company and the owner need to be carefully documented because they may be taxable or suspect in the eyes of the Internal Revenue Service. There is also much more administration involved in the upkeep of a corporation (meetings, paperwork, etc.). Most cash-poor training centers begin as sole proprietorships and partnerships evolving into corporations as they gain assets. If you are starting your business with an amount of invested dollars, you may want to begin as a corporation. Consult your tax advisor or your clerk at your local city hall for specifics on how these different business structures will affect you in your town, city or state. You my want to explore other business structures with them, such as a limited liability company. In addition, inquire about any licenses or permits you may need to establish a business in your home or community. A good source of information is your local Chamber of Commerce that can provide assistance. You may also want to contact an insurance agent to go over any insurance you may need for your new enterprise. NOTE: It is important to meet all legal requirements and local regulations for establishing a commercial enterprise, but as you undertake starting your business, don’t let yourself become bogged down in intricate corporate bureaucracy and complex organizational tables. The most essential components to a profitable and successful venture are high quality, needed products/services and clients willing and able to buy them. Consider Your Financing Options One of your goals in establishing your own business is to generate enough income revenue to at least break even, and hopefully make a fair profit. But as in any business venture, “it takes money to make money”. You will have expenses such as training aids, AV projection equipment, office and training supplies, marketing materials, possibly rent and hopefully a modest salary. This “overhead” will cost you money even before you conduct your first class. Just how much financing will you need for your new business? You will need to consider the following: • How much start-up capital will you need for the first year of business? • How much of your own finances are you willing to put into the business? • What are your opportunities for debt financing? Association loans or possibly venture capital? Small Business To start, answering those questions, speak to your accountant or the local Chamber of Commerce association in your community. One great resource in the US is the Small Business Association (SBA). The role of this federal agency is to assist small business to flourish and grow. Their website (www.sba.gov) is a helpful resource that includes tips and resources for starting and financing your business as well as information on government-backed loans. The site has online courses in marketing, administration and e-commerce. AED Instructor Foundation. All rights reserved. 2002. 6 Determine Your Products and Services Ultimately, to be in business you need two things: deliverable products and services and someone who’s willing to pay you for them. The fundamental “product” of an emergency care training business is emergency medical preparedness. Accordingly, most emergency training enterprises will generally offer a variety of programs, materials and services needed to achieve optimal readiness for medical emergencies. The services usually involve: • Conducting initial emergency medical care (CPR, AED & First Aid) training programs. • Selling patient care equipment (e.g. AEDs) and materials to clients. • Providing planning and consulting services (e.g., site or needs analysis, writing Emergency Response Plans, conducting on-site emergency drills and scenarios, performing case/incident reviews etc.). Developing a company’s offerings is what many emergency care trainers enjoy the most about their jobs. Improving existing training programs, implementing new courses, adding innovative products and services and reaching out to new markets are all part of developing your business. Initial Emergency Medical Care Training Programs Emergency medical care training programs are generally where most consultants begin their enterprise. This generally consists of independent or integrated cardiopulmonary resuscitation (CPR) programs, AED training, and/or first aid courses. Most consultants also incorporate blood borne pathogens awareness and prevention training into their repertoire of training services to satisfy government and professional association requirements also insist that potential clients have this training. Although curricula and materials vary from training agency-to-agency, conduct of all programs should be consistent with the content and timeframesset forth by the national organizations that create and accredit a selected offering. The programs shown in the table below are the most popular and marketable lay rescuer/worksite programs and represent a significant volume of emergency training center business. Note that the vast majority of initial emergency care training is conducted for workers in a variety of occupational/work sites and community settings. However, there are also healthcare provider programs that can be sold to such settings as clinics, rehabilitation centers and/or nursing homes. In many places hospitals and medical centers that once conducted their own training are now outsourcing this service. AED Instructor Foundation. All rights reserved. 2002. 7 The table also shows a common course set for a beginning training business: PROGRAM TIME ALLOTMENT Adult CPR 3-4 hours Adult CPR and AED 4 hours AED (only) 2 hours Pediatric CPR 3-4 hours Healthcare Provider 6-8 hours Refresher training 2-3 hours Fully integrated First Aid, CPR and AED 8 hours First Responder 24-40+ hours EMS Continuing Education Courses Variable Other emergency care programs can be explored and implemented based on projected marketability, local regulations and requirements, and expertise. Available Approved Programs New training companies should explore the availability of and consider offering nationally recognized, well-established emergency care programs. In addition to the well-known voluntary health agencies, there are several private publishers that have won recognition in several states and offer additional approved training options. (Links for most programs are available on the Foundation’s website www.aedinstructorfoundation.org.) Creating entirely new programs can also be an option but the development, validation and approval process is quite costly and very time consuming. Why “reinvent the wheel” when there are many good, solid programs available? Start with investigating the content and available materials as well as the operational and reporting requirements of the following programs in your area, state or country: • Heart Association • Red Cross • American Safety & Health Institute • Medic First Aid • National Safety Council • St. John’s Ambulance • The Red Crescent • National Resuscitation Councils These programs will comply with most governmental/regulatory requirements, and in the USA include OSHA’s 29 CFR 1910.151 standard when both CPR and First Aid training is conducted. AED Instructor Foundation. All rights reserved. 2002. 8 Check in your area to see how well accepted these programs are for compliance with local regulations and/or requirements. To determine this, you can contact the following: • Local Occupational Safety & Health Agencies • Office of Emergency Medical Services • Licensing authorities for: • o Nursing o Physicians o Dentists o Daycare Centers o Clinical facilities such as dialysis centers and outpatient surgery offices o Assisted Living Facilities o Local School Districts Local Public Access Defibrillation Laws Other Health & Safety Training Offerings Add additional needed training programs and related services to your initial emergency care offerings. If it is within your mission statement, branch out into other areas such as health promotion, OSHA compliance, professional continuing education, and/or other areas of health and safety instruction. Sometimes, local regulations will prompt you to think of specific programs you should offer. For example, a local law may mandate that taxi drivers have current training in defensive driving. This can create a market for you as a health and safety trainer. Explore the local regulatory atmosphere and provide services to satisfy those needs. Filling a schedule with nothing but emergency care training can be difficult in some geographic areas where work is sparse. Diversifying your training offerings is good idea to insure continued work. Sales of Patient Care Equipment & Material Certain basic tools are necessary to provide initial emergency medical care. Clients will look to their trainers and consultants for advice and purchase of these tools and equipment. A savvy businessperson will be ready and eager to meet those needs with a selection of quality products. At a minimum, a consultant should be prepared to provide adequate personal protection devices to his/her students. Most often in the emergency medical preparedness industry, this means recommending and/or selling CPR shields or mask devices to the students/clients. Especially popular with lay responders are CPR barrier devices that are packaged with gloves on a convenient means of storage such as a key chain or belt holder. Products such as these represent additional income streams for the consultant, as well as creating a total fulfillment situation for the client. Stocking these items represents a relatively small commitment of funds on the part of the consultant, and is easily within the reach of a start-up trainer. AED Instructor Foundation. All rights reserved. 2002. 9 Patient Care Material As a trainer/consultant’s client base expands, he or she should seek access to diversify and add other products. This may involve becoming a “distributor” of or “point of contact” for some patient care products such as AEDs, first aid kits and supplies and/or oxygen delivery systems. Some patient care products require some commitment of stock, sales volume, and/or initial investment. Even though distributorship of products may not be in the reach of every startup emergency care consultant, it may be possible to generate revenue on these products by “partnering up” with some existing distributors. By forming a good relationship with vendors for these products, they may allow you to represent their products in your classes in return for a percentage of the sale. A distributor may be able to refer you anywhere from 5% to 20% of a product’s cost on products that you sell for him/her. Never be afraid of approaching a distributor with whom you have a good relationship – you may be able to work out a mutually beneficial arrangement. As an affiliate member of the AED Instructor Foundation, you have the ability to make the low cost ZOLL AED Plus available to select clients. (See “PAD Support Program” on the Foundation’s website.) For clients and agencies not qualified for this discounted AED, you would be well advised to align your self with a ZOLL or other AED manufacture’s sales representative or authorized distributor. Planning & Consulting Services As an emergency care consultant, you are providing more than just training. You are selling emergency care preparedness and your expertise to help affect it. In cases where some special effort or time is necessary, you can and should bill for those services. This may include a number of different possibilities, but in general must include any expenditure of time for which you are not already being compensated. Keep in mind that your time and talents are valuable – don’t be afraid to charge a fair price for them. Site Survey/Audit/Needs Analysis If a client needs a special analysis of their locations, workspace, facilities, or paperwork, you should consider it to be a billable service. In some cases, you might not bill for time spent in preparing an estimate (such as surveying a site to determine the details for bidding on a training contract) but in general any custom work done for a client should be billed for. How much to bill for such services is highly dependent on the market you are working it, the complexity of the work, and your personal skills and self-valuation. Keep in mind that most professional services (accountants, programming) are billed out at the rates of around $65 - $85 per hour. Companies (and to some extent, individuals) are used to paying that for advice that they value. Initial Emergency Care Response Plans Writing and implementing emergency response plans is another area where consultants can provide a needed and helpful service. Many corporate and safety managers are uncomfortable with writing policies and procedures and gladly outsource those projects. A good consultant will stand ready to provide that service as a billable item on a project. Developing and implementing a reasonable and appropriate Emergency Medical Response Plan requires the integration and coordination of several separate but interdependent activities, entities and components. The following could serve as a “draft” outline of such a plan: AED Instructor Foundation. All rights reserved. 2002. 10 • Patient Care Protocols – Written guidelines for generally accepted emergency medical treatment procedures to be followed at the time common life-threatening medical emergency. • Human Resources – Specific emergency care roles and responsibilities of all clinical, administrative and clerical staff. • Training – Emergency medical care training standards for all appropriate personnel. • Communications and Consultation – How and when to contact Emergency Medical Services as well as how to utilize “911”, tele-medicine and Emergency Department advice services when appropriate. • Equipment, Supplies and Pharmaceuticals – Listing of emergency medical supplies, equipment and medications that should be stocked and utilized as needed; and procedures for maintenance and inventory control. • Record Keeping and Documentation – Procedures for recording findings, actions and emergency care rendered • Transportation – Guidelines for transfer of emergency patients to appropriate definitive care services via available transportation services and suggested interactions with and ”hand-off” of patient to EMS personnel. • Medical/Specialty Care Facilities – Appropriate medical control services and health care facilities as well as specialty physicians to be utilized in specific clinical situations. • Drills – Procedures and guidelines for conduct and evaluation of regular on-site emergency care drills and scenarios. • Management and Evaluation – Procedures for specific case analysis (including AED Medical Control), individual care provider performance and periodic Emergency Medical Response Plan review. On-Site Drills and Scenarios Serious emergency team building requires more than a re-certification every two years. Although some clients are difficult to convince, some actively encourage skills retention and increased learning by hiring consultants to run drills and scenarios at their company periodically. This can range from having the consultant do short learning sessions during the monthly emergency team meeting, to quarterly or semi-yearly skills review sessions. Provide clients some options for refresher training – many of them will be interested. Case Review/Quality Control Another area where consultants can help clients is with case review and/or quality control. Consultants can meet with responders, analyze response times and effectiveness, and try to offer constructive criticism and expert analysis in an effort to improve a client’s emergency response system. Note that most AED regulations require that a qualified physician must review downloaded EKG data following the use of an AED. AED Instructor Foundation. All rights reserved. 2002. 11 Setting Up THE LOGISTICS OF Your Business Even though most instructors/consultants start with a small venture, there are many needs and expenditures that come along with running a business. These are simple things that most employees take from granted, but most business owners need to include in their budgets or business plan. You will need to consider where you want to locate your business and in which ways will you communicate with prospective clients. “Work/Storage” Space and Location Most trainers begin by working out of a home office with a garage or shed for storage space. Whether you work in your home office or your garage, you will need some basic office and communicate equipment. As your business grows and needs increase, you may consider acquiring larger (rented) space. If you are starting with one manikin and a dream, it may seem silly to hear that storage space is a consideration. As you build your client base, so builds your inventory. Manikins need storage, as do books, barrier devices, and AED trainers. A consultant with any kind of volume quickly finds him/herself with 20 or 30 coworkers and a few boxes of supplies. If you live in a suburban house with a nice big garage, this may not be a big consideration. On the other hand, if you rent an apartment in a bustling city, you’ll need additional space quicker than you think. Mailing Address Your choice of what to use for your mailing address is a matter of personal preference. Some trainers like to use their home or office address, while others prefer to utilize a post office box to maintain privacy. Keep in mind that if your home mailing address is too residential-sounding (Beverly Hills Residential Complex, Apt 4-A) it may turn off potential clients who may feel that you may not have the resources to handle the project. To not influence prospective clients in this way, it might be a better option would be to use a post office box. Clerical Support Clerical support is a luxury that many smaller consultants cannot afford in the beginning of their careers. Like any small business, it is often the owner that performs the more mundane duties such as phone answering, letter writing, billing, accounts payable, and other duties. As the training business grows, there will be a time where the owner finds him/herself with more money than time. In instances such as these, an assistant can be of tremendous value. By hiring someone (even part time) to perform some of the more common duties outlined above, a consultant can focus on more specialized tasks, such as performing billable services, sales, and/or market research. You might want to consider getting a business card that provides a way for prospective clients to contact you. You can use your business address, fax and telephone numbers, and your email or web site address. Creating a logo that identifies what your business does “speaks” for you and it is important to present a professional image. Most nation chain stationary stores will print business cards and stationary at a reasonable cost. Suppliers Your suppliers are important resources in running your business. When shopping for the day-to-day supplies necessary to run a training business, consider the supplier’s payment terms, credit arrangements and service in addition to price. Also, be sure to keep your suppliers satisfied with your payment schedule. They are often invaluable assets when you need additional help, quick deliveries, or additional credit to handle a big project. AED Instructor Foundation. All rights reserved. 2002. 12 Office Equipment Personal Computers and Printer Just about any business in operation today needs at least one computer and high quality printer. It is absolutely indispensable for activities such as billing, letter writing, data collection, and communications. The good news is that any relatively new (last 4 years or so) personal computer should be adequate for light business use. You might want to consider purchasing a computer especially designed for a home business. Such a computer would have adequate hard drive and storage space and enough memory to hold several software programs (word processing; financial programs). Any of the larger computer companies’ technical services departments can advise you of the best system to purchase for your specific needs. In addition, consider purchasing a high quality laptop that you could use in your office as well as at a client site. Laptop computers are essential tools for high quality audiovisual presentations at client sites. If you are unfamiliar with how to use a computer, enroll in a computer course at an adult education facility or computer store in your area. These courses are usually inexpensive and familiar with popular word processing software and other office applications. Telephones Good communications are extremely important. Luckily, telephone service has been getting less expensive every year. The same goes for digital phone service. At minimum, any consultant should have a business phone number, a modem/fax line, and a digital phone (in case you get lost going to a client’s site or hit traffic). If finances permit, you should consider a toll-free phone number. Many clients will call the free number first simply because it costs them nothing – that gives you the opportunity to make a good impression first. Telephone service cost varies from area to area, but it is wise to anticipate a cost of around $100 Fax Machine A fax machine is a good investment. Today, you can purchase a fax machine that will serve as a printer, photocopier and a scanner for at a relatively inexpensive cost. Consider getting a dedicated line for your fax machine so as not to tie up your telephone when speaking to a client. Online Communications/ Internet Service Provider and Email Any business today cannot succeed unless they are “wired” to the electronic world we all depend on to conduct business. At minimum, you will need an email address and in the future consider a website that reaches a large audience. You will need an Internet provider (ISP) so you can contact customers via electronic/E-mail, search the World Wide Web or set up your own website. If you already have an Internet provider, check to see if you can have more than one account name. In this way, you distinguish between your personal and business email. Email is an indispensable communications tool for modern business. It provides almost immediate ‘written’ access to data, sends and receives pictures and documents, and in general transfers thoughts between people with almost no cost and no intrusion on one’s schedule. A consultant without an email account will often find him or herself missing out on opportunities. When establishing an email account, the optimal format is an email account that combines your name and website ([email protected] ). Be weary of using email addresses from free email services ([email protected] ) for business purposes – consumers tend to associate them with a lack of resources on your end. AED Instructor Foundation. All rights reserved. 2002. 13 Audiovisual Presentations/Materials Having good audio-visuals is an essential component of effective emergency care training. It’s also expected to have an audiovisual presentation in the corporate training environment. Today, clients in the corporate or non-profit world expect a polished, professional presentation. Teaching a training class with a marker and a white paper flip chart isn’t going to make the desired impression. Most accrediting agencies for the program you select will provide some form of audiovisual support for their program. Some go as far as mandating that you use that specific format. This may include videos, slides, or graphic design software packages. Developing your own materials, especially when they are specific to a training site is also a nice touch when teaching programs. Investing in a laptop computer is one way to produce a quality audiovisual presentation or supplemental/customized material for your client. Audiovisual Projection Equipment Having a great video or slide presentation is nice, but without the means to present it they don’t mean much. Although some sites may have some equipment available, it is unwise to count on their equipment for your programs. A smart trainer is going to own everything he or she needs to conduct the course and arranges for back up in case of equipment failure. You may not have to bring it with you but at least it’s available. If you find yourself doing a lot of video-based training, a combination TV/VCR may be a good investment. Of course a portable TV tends to be fairly small, which means that if you must use your own screen, you are probably limiting yourself to around 13”. This size screen is viewable by only 10 people at best. A portable TV/VCR of that size costs a little over $200. Slide projectors were for years the standard for displaying static material for lectures. Program publishers nowadays are doing less and less in costly 35mm slide in favor of inexpensive-to-produce digital presentations such as Microsoft’s PowerPoint Unless there is a very specific need for a particular program, it is not recommended that a beginning trainer spend money on a slide projector Your laptop computer can serve the same purpose. An LCD projector accompanied by a laptop computer is the gold standard for sophisticated presentation. While not cheap, this set up is highly adaptable, can have multiple presentations loaded on to it, and most presentations can be easily changed or new ones created. It also requires very little from the site other than a screen or blank wall to project against. When looking for an LCD projector, be sure to select a unit with at least 1000 ANSI lumens of brightness. Any less than that and you run the risk of the presentation not being visible in bright rooms where the ambient light cannot be controlled. Even more lumens is better. If you select a unit with standard AUDIO IN and VIDEO IN ports, you can also display VHS tapes with the help of an inexpensive VCR. You can find a new LCD projector with the above features for around $2000. A laptop computer can cost around $1000 if you can live with something that is not latest technology. There are devices called “Digital Slide Presenters” that can take the place of the laptop if you don’t mind static PowerPoint presentations with no animation. Digital Slide Presenters cost around $200. Most instructors do not anticipate the expense involved in the training supplies necessary to adequately run a commercial training business. They are not always aware of the expectations that individuals have when attending a fee-for-service AED Instructor Foundation. All rights reserved. 2002. 14 program. You will need to invest in purchasing up-to-date audiovisual equipment that you can use at a client-site presentation. Patient Care Training Aids / Materials Anticipate needing additional training aids and materials in addition to books and manuals. These aids will include some pocket masks, bag-valve-masks, if you plan on teaching professional rescuers, AED trainers (a potentially large expense at around $300 - $500 each), and miscellaneous supplies such as first aid kits and bleach. Manikins Commercial trainers tend to make very different manikin purchasing decisions than other training organizations, such as Red Cross centers and hospitals. Since so many commercial trainers have to travel to the training sites, weight and portability of a manikin becomes important factors. In addition, most consumers (especially at the corporate level) are used to having very sanitary – almost disposable – supplies. As a result, equipment that eliminates the sharing of a manikin surface between students is important. Using the alcohol method of cleaning a manikin between students is not wrong in any way; but it is suspect in commercial training, as clients will expect better and more sanitary equipment. A recent trend has been the move towards providing each student with his/her own manikin. This decreases student idleness, increases practice time, and ultimately provides the participant with a greater feeling of accomplishment and satisfaction with the program. Such individual use manikins are also popular because they eliminate the need to clean manikins between students. These small, personal use manikins retail for around $40 - $70. They are often less expensive when purchased in multiples. Other manikins utilize a plastic bag barrier. The drawback to this system is the fact that the plastic face shield manikins tend to require disassembly and lung replacement before another student can use it. As a result, they do not lend themselves well to sharing between trainees. If sharing a manikin is absolutely necessary, a more costly removable face unit may be a wiser investment. These manikins are generally larger and more durable and have removable face or mouth areas. Each student would be assigned his or her own mouth area to practice rescue breathing. When the student finishes practicing, the mouth area is removed and a new student inserts his/her mouth area and takes the position by the manikin’s side for practice. Removable face manikins cost around $150 - $250 each. Another money-saving tip is to purchase a manikin that can be used as an adult and a child model. Many manikins (particularly individual use manikins) have adjustments that toggle the compression depth between adult and child requirements. This eliminates the need for an additional manikin size. While this can save considerable amounts of money (and hassle in carrying all those manikins) some trainers prefer to use a specific child manikin, especially if they teach significant amounts of pediatric CPR. Books and Printed Materials A trainer, like yourself, must keep a supply of manuals on hand for your programs. What manual you choose is probably more dependent on the accrediting agency you choose than the manual content, since most agencies will require that you use their publishing. Keep in mind that a busy trainer will probably be more affected by the per person cost than the up-front cost of purchasing a video or teaching kit. For example, if a training system’s AV set costs $100 more than the second, but their student materials average $2 less, you AED Instructor Foundation. All rights reserved. 2002. 15 will make up that additional up-front cost in 50 students. Per student book cost is a major factor in determining pricing and cost for a commercial trainer. Try to keep enough stock to get you through your anticipated volume for at least two weeks. This will insure that if you need to order additional manuals you will have time to do so and with a few days to spare. The question often arises if students really do need a book or manual? If the training is to be more than just a “time consuming exercise,” the answer is a definitive: Yes! A simply written, well-illustrated book or manual is an important tool for each student to take away from the program in order to help make the emergency care learning process an on-going activity. Participants can use these documents to refer to as well as serve as a reference point for sharing their newly acquired knowledge and skills with family or friends. Insurance Having proper insurance coverage is a necessity for any business. Determining just what type and how much insurance is needed for your enterprise will take time and some investigation. Insurances you may need to consider are: • General Liability • Loss or Theft of Office Contents or Training Materials • Malpractice • Workers Compensation • Health and Disability/Lost Wages Financial Management In any business you are involved in, careful attention should be paid to the dollars coming in and the dollars going out. You might be the best trainer in the world, but if your income does not exceed your expenses you are still not succeeding in commercial training. Setting Fees for Service and Price Lists The price list is often where a well-meaning trainer fails to use good judgment. Even though some markets that need training are somewhat cash-poor (consumers in poor neighborhoods, small businesses such as daycare centers), as a trainer you need to charge an amount that will keep your business afloat and provide you with some returns on your investment. When your business grows, those receipts must also support the additional administrative and sales people that do not directly generate income. Remember this: YOUR SERVICES ARE VALUABLE, AND YOU SHOULD CHARGE ACCORDINGLY. If you are satisfied teaching for $15 - $20 an hour, you need not become self-employed. There are many hospitals and existing commercial training agencies that will pay you that to work for them. Save yourself the investment, hassle, and risk of running your own operation. As mentioned before, any professional service will charge around $60 - $125 per hour. You should do at least the same. Plus don’t forget to charge for materials and also, where necessary, related travel expenses. One way to compute a price list is to do a cost analysis of the program and establish a price by working in your “profit’ goal. Add the following together: AED Instructor Foundation. All rights reserved. 2002. 16 • Cost of course materials and supplies • Cost of staff • A margin for cost recovery of office expenses, advertising, etc • Desired profit margin • An overflow of 10% or so Here is an example for a short CPR program of about 3 hours for 10 students: Cost of materials and supplies $4 manual/card and $0.50 manikin lung $45 Cost of staff $25 per hour for 3 hours, (depending on the market) $75 Miscellaneous Expenses $20 Desired profit for the company $200 Overflow TOTAL $30 $370+ Keep in mind that this figure is not representative of the average price – it is an example. In some markets this is expensive, and in others it is a bargain. Be sure to also quote for additional line items that may not be entirely obvious at first such as parking or travel. Banking Services At minimum, a trainer needs a commercial checking account with the business name on it. Business consumers sometimes get the idea that you cannot handle large jobs when they perceive you to be a small operator. A dead give-away is when you ask them to make the check out to “John Smith”. A business name is important so that consumers know that they are dealing with a full service agency, not just one person (even if it really is only one person doing all the work). You don’t need to lie to people by making up additional non-existent staff members (that always makes you look silly) but give the impression that you are professional and well staffed. As early as finances permit, you should consider credit card acceptance for your organization. Many corporate and industrial buyers are now using company credit cards to purchase up to several thousand dollars of goods and services. Taking credit cards can often make or break a sale. Working Capital / Lines of Credit There’s an old cliché in business: “it cost money to make money.” It certainly won’t be tens of thousands of dollars, but you will need some start-up and/or working capital to begin your own business. It’s always nice when you can use “OPM” (other people’s money) to finance your business venture, but in the world of small business if you want YOUR business to succeed you will have to invest a lot of YOUR time and talent and a little of YOUR money or assets. In short, if there are no risks to you there will probably be little or no rewards. If you have some savings to start your training agency, it can keep you funded for the initial period of operation when the money is tight. If not, there may be some AED Instructor Foundation. All rights reserved. 2002. 17 small business financing options at reasonable interest rates available from your local bank. Be realistic – being a trainer/consultant is not about opening shop and counting the waves of money coming in the door. Like almost any other business, it requires growth, investment, and time to develop. You may not see a profit (or perhaps not a large one) in the first year or two. Most consultants report not making enough to sustain their livelihoods without a second job for at least 18 months. Debt /Payables Suppliers generally expect payment in around 30 days, and dragging on your supplier’s payments can cause them to cut you off or withhold shipment. Also, interest paid on company credit is generally a tax write-off. Be sure to keep those expenses separate from your personal ones. Where possible, try to use more reasonable lines of credit such as small business loans to finance your company. Avoid the use of credit cards and their high interest for making business purchases. Also, lines of credit with vendors are helpful, but if you think it will take some time before you can pay it off, you may be better off using your bank loan. Payroll As soon as a large class presents itself or the schedule starts to get full, you will have a need for additional instructors. Anticipate that need by seeking staff BEFORE you need it. One of the best reasons for keeping a per diem position with a local training center (ideally non-commercial training center such as a hospital) is to make contacts and find additional staff. You can set staff up in a few ways: Full time people are the ideal employee. Their time is generally dedicated only to you (although they may have additional part time jobs) and as a result, you can expect the most of them. Full time employees are also the easiest to mold, as they are around you 40 hours a week and thus are more exposed to your way of doing things. Full time employees are also more difficult to finance – they require steady salaries, benefits, and other compensation that must be provided every week without fail. Part-time Per Diem positions are the norm in this business. Most training centers keep a list of per diem staff that are called upon then the schedule is busy or when some large classes are expected. Per diems are not guaranteed a certain number of weekly hours (although some part timers may be), and thus only get paid when they are out making you money. The drawback to per diem staff is that their less frequent activity can make them less experienced. They may also not be familiar with how you like things done. Per diems also may need additional financial incentive to come out and work for you – generally more than what they might make at their normal full time job. You might be able to find an instructor to work for you at $16 per hour full time, but will not per diem for less than $20 (as this represents his giving up his free time to work). Lastly, per diem employees have little to lose if things go wrong. If they don’t show up to a course, they only lost 4 hours of pay and the potential for another 1 or 2 jobs per month. You’ve lost a client who will probably never call you back. This is a little different than a full timer who would lose his/her living. Although per diem help can be extremely competent, they have to be selected carefully. With some luck, you may find a couple of professional instructor who makes a living by holding per diem jobs at 3-4 training centers. This type of ‘instructional mercenary’ is generally very familiar with the business and often willing to take on another per diem slot to keep their schedule full. AED Instructor Foundation. All rights reserved. 2002. 18 As far as payment is concerned, the average training agency keeps per diem instructors as contractors on a 1099 reporting system. Although this practice is widespread (is it easier to do this and file the 1099 form for a per diem than to put them on typical payroll, pay payroll taxes, and secure worker’s compensation), it is a somewhat controversial practice. There are very specific criteria for an instructor to qualify as a “1099” consultant. Some might argue that a person who is hired to perform labor that you control with your equipment tends to fit the definition of an employee more than a contractor. If so, this would require that your training center place this individual on traditional payroll with the implications mentioned above. It is not the intention of this document to provide you with taxation or legal advice. Please be sure to consult your tax advisor for particulars about contractor vs. employee issues in your particular state. Bookkeeping Someone who has never run a business is often surprised at how much is involved with keeping track of finances. Expenses must be verified, income must be tracked, payroll hours must be accounted for, and there may be even more details for incorporated businesses. At minimum, any business should carefully track: • Accounts Payable • Accounts Receivable • Receipts • Payroll • Taxes (estimated, sales, or otherwise) A good accountant will provide advice on the best system to implement and how to track your accounts. He or she can often also offer helpful advice on other financial issues, such as special tax reporting (sales tax, for example) or how to collect special tax incentives (such as the New York state law that gives corporations a $500 tax break for buying an AED). Financial Projections Be realistic – being a trainer/consultant is not about opening shop and counting the waves of money coming in the door. Like almost any other business, it requires growth, investment, and time to develop. You may not see a profit (or perhaps not a large one) in the first year or two. Most consultants report not making enough to sustain their livelihoods without a second job for at least 18 months. Support Services & Resources There are many organizations that provide information, support, and general assistance to start-up companies. Some of these organizations exist to support small business, while others are dedicated to the increasing the availability of emergency care training. AED Instructor Foundation. All rights reserved. 2002. 19 Small Business Administration The mission of the federal Small Business Administration is to assist small businesses to flourish. Their website is an extremely helpful resource that includes tips and resources for starting and financing your business, details on governmentbacked loans, and even a number of online courses in marketing, administration, and e-commerce. This is a terrific place for initial research on the web – http://www.sba.gov. AED Instructor Foundation Recognizing the importance of public access defibrillation programs, and the crucial role and needs of instructors who help to develop them, the AED Instructor Foundation was created by a group of experienced emergency care educators. It is the goal of the Foundation to assist and support initial emergency care instructors in their critical function of preparing communities and workplaces – especially public gathering places and small businesses – for reasonable, appropriate and effective emergency medical response. The AED Instructor Foundation is a not-for-profit organization that serves as a resource center for information, material and innovations related to AED and initial life support training procedures and related program implementation activities. The Foundation is solely dedicated to this mission and will work closely with other interested organizations and agencies whose charters include commitment to teaching, learning and/or providing initial life support and immediate emergency care. To help promote and provide Public Access Defibrillation and help insure effective initial emergency care preparedness and response needed in homes, workplaces and other community settings, the AED Instructor Foundation provides educational materials and services to assist and support first aid, CPR and AED instructors. As Affiliates, qualified instructors can freely access an informative, comprehensive web site with links to key AED and initial emergency care training recourses (including the National Center for Early Defibrillation). Affiliates are recognized as part of an international Registry of certified initial emergency care educators. The Foundation has also developed a detailed “Instructor Code of Professional Ethics and Standards” that each affiliate must agree to follow. Affiliation with and membership in the Foundation is free of charge to eligible individuals. In addition to a variety of free tools, resources and support services available through the Foundation, discounts on some commercially available instructor needed products and services (such as instructor liability insurance) will also soon be available. Affiliates can also attend inexpensive, informative workshops and seminars designed to help enhance their presentation skills as well as increase their training company/organization management abilities and boost their PAD promotion efforts. State Universities/Community Colleges Your local institutions of higher learning probably have a number of courses that a budding AED entrepreneur would find helpful, such as basic accounting, marketing, public speaking, and economics. Some of the more business-oriented programs may be part of the continuing education and/or adult school programs rather than actual college-credit programs. AED Instructor Foundation. All rights reserved. 2002. 20 Peer Groups/Professional Associations There are a number of professional and peer organizations that can provide start up consultants with some credibility, resources, and networking opportunities. The National Association of Emergency Medical Services Educators (www. naems.org) is the classic national EMS instructor organization. While they generally deal with the teaching of professional rescuers, they are now addressing lay responder education through their ‘Pre-EMS Forum’. The National Safety Council is a well-known entity in general industry. With your membership comes a number of publications that keep you up to date on OSHA and other safety and regulatory matters. You also receive a large member certificate. Since so many large companies retain membership in the council, some people interpret membership as a sign of a quality and responsible operator. http://www.nsc.org. Local groups may also be helpful to a trainer trying to establish him/herself. Your state may have a local association of EMS instructors, safety consultants, and/or medical equipment suppliers. Seek out these organizations and try to use them for networking, subcontracting, and referral opportunities. If you like to socialize (and if you are good at it!), the hand that you shake today may call you tomorrow with a great lead. Don’t be afraid to hand out a business card at an industry event. Other Training Centers Technically, your neighboring training organizations are your competition. There is no reason that this competition cannot be friendly. If you have a competitor that seems approachable and that does quality work, establish a friendly relationship with him or her. Having that relationship can enable you to borrow some equipment when you are short, get relief for a program that is understaffed, and/or just have an additional person for industry advice. Legal Consultation and Services While many consultants begin their ventures without the benefit of legal advice, there will come a time where some professional legal counsel will be necessary. As soon as feasible, you should consult with an attorney to review company framework, disputes, collections matters, and any extensive advertising in which you may need to engage. Personnel and Staff The principle “commodity” of a training company is the human resource called instructors. What training companies sell is the individual instructor’s time and talents in the form of a training classes and consulting services. Unless you do all the training programs and client services yourself, the quality of your staff you select to work with you is the number one factor in the success and growth of your enterprise. We can divide a training center’s staff into three categories: • Instructors who conduct training • Consultants who perform specials projects, such as perform analysis, program writing, and special customized programs for clients. • Sales representatives who sell the agency to potential clients AED Instructor Foundation. All rights reserved. 2002. 21 If you are the average emergency care entrepreneur, you will end up performing all of these functions – especially in the beginning of your business. Instructors Instructors are the ‘foot soldiers’ of a training agency. They perform the bulk of the work that the client sees. They are also in the best position to make a good impression on the client, as they are delivering the product that the client ordered (the training). The performance of an instructor can make a client sign on for life or never do business with you again. As a result, it is important to make good choices as to who to hire to work with you. Try not to base your recruiting decisions solely on an instructor’s clinical background. As a general rule, having a clinical background (EMT, Medic, ER or critical care nurse or a physician) affords the instructor excellent credibility. However, initial emergency care instructors must also possess excellent communication and interpersonal skills, especially when dealing with non-clinicians. They must also be punctual, professional, has a good demeanor in a classroom, and be able to work through problems that may arise during a course without letting their program derail. There are also many excellent “non-clinician” instructors who meet these requirements. However, it is important that at some point in their instructor training and development they have had direct involvement with an effective initial emergency care clinician instructor or instructor trainer. In First Aid, CPR and AED instruction, trainers who have been trained by trainers, who have been trained by trainers, who have been trained by trainers – tend to loose sight of the patient care goals and weaken the overall effectiveness of their programs. Consultants Consultants in this business are typically instructors who have collected enough background and experience that they can comfortably adapt the principles of emergency care to a facility. They are generally well schooled in clinical matters and regulatory requirements. They are abreast of new products, legislations, and science that can affect the industry. They also have the benefit of having worked with several other organizations/clients in the past, and have a good sense of what works and what does not work. As there is not yet a formal program or workshop to become a “certified” consultant – achieving this level of expertise is the result of teaching, studying, researching and having a genuine love for the industry. Sales Representatives Since most emergency care instructors and consultants are EMS or Healthcare Providers, they often over look the value of a professional, dedicated sales force. Keeping enough business coming in the door is critical to organizations that operate on a fee-for-service basis such as training centers. Having a designated sales person (even part time) is incredibly helpful for attracting new clients, as well as for retaining the existing client base. As soon as your finances permit, hire or train someone to do sales for you, or dedicate some of your own time to regularly calling on existing and prospective clients to sell and re-sell your services. Professional Development The worst thing an instructor/consultant can do is to assume that they know everything or at least enough to “get by.” Not only is emergency care very dynamic, it is also different from environment to environment. For example, Syrup of Ipecac is no longer an intervention that is taught to EMS providers, but AED Instructor Foundation. All rights reserved. 2002. 22 Poison Control Centers still recommend its use to lay people who contact them. An instructor with an EMS background may easily overlook the value of this treatment at the community level. When teaching first aid to a daycare center it is important to cover Ipecac even though it is not an ambulance intervention. Staying on top of trends, products, and patterns is extremely important. Instructor Training Initial training for instructors generally consists of the regular workshop provided by the accrediting agency that you are using. It typically consists of a 2-3 day course (depending on how many disciplines it is preparing the candidate for) that explains classroom dynamics, ethical and legal issues of teaching, structure of the organization, and allows for some opportunities to do practice teaching in front of the class. Be weary of “quickie” instructor courses – these are typically nothing more than ploys to sell materials such as books and “certification” cards. Instructor training is a base of education to build on, but rarely does it produce instructors that are ready for commercial teaching. There is a significant learning curve for instructors where they learn to manage the training environment, deal with troublesome students, handle equipment problems, and to assert themselves in front of an audience. Remember, an instructor’s card is an authorization to teach through that organization – it’s not a guarantee of competence. If you are sending people out on commercial teaching jobs just because they have an instructor’s certificate, you are setting yourself up for failure. Allow instructors to have a phase-in period where they act as a second to or work as a “skills instructor” with a more experienced instructor for a while. Curriculum Development & Customization Most instructors teach courses that have been developed by someone else (so called “canned” courses from national training organizations). Curriculum development can however, be a creative and rewarding experience. As a training agency, you should seek out markets that are under serviced by the current programs out there and create solutions for them. You can also adapt existing curricula without modifying their major objectives to better satisfy an audience. For example, in teaching adult CPR to a nursing home, you may have them work out of their crash cart to breed familiarity with the equipment. You might also have them document the event on their resuscitation chart to gain practice at writing emergency events, and even fake the transport phase with a stretcher. Although it is still the standard adult CPR course, you might market it as “Long Term Care Code Blue.” This mini-curriculum is an adaptation of an existing course for a specific market. You may also have found a niche that needs a brand new program to be written from scratch. Perhaps you’ve discovered that your state requires that nursing aids have 20 hours of continuing education to re-certify their credentials. You may be able to create ten short in services programs on nursing aid topics such as infection control and back safety. Then you can submit these programs to the Board of Nursing for accreditation. You may then be able to sell these programs to extended care facilities, nursing agencies or other local agencies. Public Speaking & Presentation Skills Instructors need to be comfortable in front of people – period. You cannot realistically make teaching your living if you dread public speaking. On the positive side, this fear of standing in public and speaking tends to disappear after the first few classes. It is simply a matter of experience and practice. One of the things that is critical to a new instructor’s development is working that initial awkwardness out of him or her. AED Instructor Foundation. All rights reserved. 2002. 23 Once one has achieved some comfort in front of a group, there are ways of finetuning one’s performance. One way is to take a college-level public speaking course. This may provide you with some of the ‘rules’ of public speaking and give you some opportunities to practice under the critical eye of your professor and the rest of the class. Most instructors develop simply by watching others. They analyze other instructors and ‘borrow’ something that they like – a purposeful pause, a gesture, or a phrase. Borrowing is very common in this industry. Don’t feel bad about taking someone’s trademark bit – it really is the ultimate form of flattery. Evaluation Regardless of how competent you think your staff is, you MUST evaluate their performance periodically. This is especially true if they teach a lot of small jobs alone. It is very easy for an instructor who is isolated from other instructors to teach something incorrectly for years because they have never seen it done differently. This even happens at the training center level when the head of the training center does something incorrectly and it is then passed down to the instructors and ultimately the students. Do not be afraid to evaluate both your personal performance and that of your staff members. Remember, we constantly ask our students to give up techniques that for years they have thought are correct (butter on burns, tilting back the head on a nose bleed). We should be graceful enough to change along with them when something new or better is discovered. Continuing Education Teaching any level of emergency care requires a lifetime commitment to learning. Emergency care is heavily based on science, and as we all know science changes. New CPR guidelines are released, a defibrillator company releases a new waveform that produces better results, or the FDA recalls a product that everyone still seems to be using. This is the sort of thing that instructors (and particularly consultants) must be aware of. Even if you as the training center manager are aware of them, you have to roll out these changes to your staff. Unfortunately, it is not uncommon to see an instructor who is still teaching the 1991 CPR guidelines in 2002. This is unacceptable for a professional, commercial instructor. Find the time and the money to attend national or regional workshops and conferences sponsored by the agencies whose programs you teach. Participate in instructor peer groups. And above all read, read, read. The Internet has many excellent websites with tons of information and up to date data relative to initial emergency care. For example, the National Center for Early Defibrillation maintains an excellent website (www.early-defib.org) with the latest research and information on AED and PAD programs. (The AED Instructor Foundation site also provides much useful information and links to other informative emergency care and AED sites.) Internships & Mentoring If you are just starting out, it’s a good idea to find some work with a local training center or business to learn the basics. The best experience comes from working with a busy commercial outfit. However, if you represent competition to them, they may be reluctant to train you or to take you to their clients. You can seek out a commercial training center in another state, for example, and spend a week or two with them to “learn the ropes.” You will not present a “competition threat” to them, and they may welcome an assistant instructor that they do not have to pay. (But nevertheless, be prepared to sign a non-compete agreement.) This will give you an idea of how to manage class dynamics, customer service, and probably give you a few tips that you may not have thought of before. Remember, most trainers and consultants who make a living at this AED Instructor Foundation. All rights reserved. 2002. 24 learned by trial and error. They all made mistakes and (hopefully) learned from them. Seeking out a training center, staying at a hotel/motel, and being the intern may sound like a lot of hassle, but it may save you thousands of dollars in costly mistakes over the course of your career as well as enhance your venture profitability. It could well be a very wise investment. If you cannot get away for a week or two, you may also benefit from sitting in an observing a couple very good instructors in your area, and doing so more than once. Although a commercial training agency generally is closer to what you want to achieve (and thus a better education for you), any experience in the classroom is better than no experience at all. It will at least teach you student management, proper administration of a program, and possibly some good technique if they buddy you up with an experienced instructor. Ultimately, keep in mind that training centers have biases and/or prejudices as to how they do things. Sometimes an instructor can intern with a group and pick up those prejudices. These prejudices are related to equipment, time frames for courses, and content. Learn from the center that you intern with, but remember that the ultimate places to seek information are the materials from the national organization whose program you are teaching. You should also select your mentor training center very carefully - there are a lot of poor quality trainers in operation. As a general rule they should be offering courses that are consistent with the outlines that are in your instructor manual. If the content and/or course length, for that program seem way off, you might consider looking for another mentor. Sales and Marketing Most new consultants describe finding new clients, or sales and marketing, as the hard part for getting your business off the ground. Establishing a client base is not easy – especially a client base that results in your sole source of income. Once the equipment and logistics are set up for the task, you need to seek out some clients. People will have a variety of reasons why they need or utilize your products and services, and you need to identify those reasons to seek out those clients. It is all a matter of perception and motivation. Public perception can be a powerful motivator when consuming goods and services. For example, there is a rumor that a defibrillator company is in negotiations with a popular car manufacturer to build an AED as an option into one of their luxury models. Now any good consultant knows that getting into a car crash is not likely to throw you into a shockable rhythm where AED would be useful, but the public perceives roads as being dangerous and isolated. As a result, the AED-in-the-car concept may have some marketability. Look for markets that perceived themselves as needing to be prepared for medical emergencies, such as hospitality workers, divers, daycare providers, and small healthcare establishments. You should also keep in mind that perception does not always provide you with a guaranteed client list. Most people perceive restaurant workers as needing to be prepared, but the food service industries are typically not purchasers of CPR/First Aid training. Some clients are motivated by a sense of safety. You can sometimes catch that audience at a trade show or safety exposition. Other clients have regulatory requirements from a licensing body and/or overseeing body (such as OSHA). For AED Instructor Foundation. All rights reserved. 2002. 25 others, they may have had a bad experience with an emergency event, and they are now preparing themselves so that they are not surprised again. Whatever the motivation, you should make an effort to capture that potential client’s attention. Whatever their motivation, they represent potential work for you. You can do that by networking, telemarketing, or making your business visible by participating in trade shows and public events. Networking/”Word of Mouth” People using the services of the “service industries” tend to do business with those they know or are at least, are known by those they know. Talk to friends who are likely to need your services or who know people who manage or operate businesses or facilities that can benefit from your expertise. Your first clients are most likely going to be people who know you. Try to create some links to the markets or industries where you want to focus. Join or offer to speak at trade associations or community service organizations or clubs (like Rotary or the Lions.) Many times, business comes your way simply because someone heard of you before. Join Internet lists and discussion groups, go to conferences, and try to get material published in industry newsletters and/or magazines. Increasing your visibility almost always increases your business – especially if you make a good impression. Telemarketing With today’s office environment of voicemail and answering machines, some organizations do less phone solicitation than in the past. “Cold calling” is still a viable means to reach potential clients in some industries. A well-placed call to a safety coordinator at a company can still yield a great client. Try to be considerate of the client’s time and schedule however – an easy way to lose an opportunity is by being too persistent. Distributing Printed Materials Brochures and fact sheets are almost assumed to be available for any product or service. You must have the ability to provide consumers with more than a oneparagraph blurb of your services if you expect consumers to be interested in buying from your services. Be succinct in your description of what you can offer. You can create your own brochures or fact sheets by using a desktop publishing package and you can find some attractive business quality papers for brochures and fact sheets at a local copy shop or online supplier. When time and finances permit, consider upgrading your materials to a professionally printed brochure or training catalog. Several excellent downloadable sales and marketing tools can be found on the AED Instructor Foundation website. Advertising There is a lot of truth in the old cliché “it pays to advertise.” Unfortunately, to do it right, running adds in local and/or national media outlets (news papers, TV, radio and/or magazines can be very tricky and quite expensive. You may wish to start small with classified adds or so called “business card” adds in community newspapers. Another inexpensive way to advertise is by hanging a notice on community bulletin boards (such as found at Malls and Super Markets) or buy space in church bulletins and news letters. AED Instructor Foundation. All rights reserved. 2002. 26 Website - Yours and Other’s Many people may doubt the value of the Internet in selling local services, but there are several websites devoted to CPR training on the Internet. They are very effective at promoting emergency care training and products to potential clients. Establishing a website appeals to corporate consumers who are very used to using the Internet for finding vendors or to learning more about a potential vendor. To provide another revenue stream, you can even sell associated products over the Internet such as CPR barriers, AED accessories, and other first aid gear. When creating a website, remember that you get what you pay for. Hosting services range from free (http://www.geocities.com or http://www.juno.com) to fairly expensive. Free services charge you nothing, but often display advertising on your website to defer the cost. Consumers (especially corporate consumers) know the difference between a website that was started with no money in an hour and professional looking work. Spending a few hundred dollars on a good web presence is almost always worth the investment. Either hire a webmaster, a specialist in creating web pages for clients, or use a website creation program to create your own which then can be hosted at a service. A number of websites (including the AED Instructor Foundation and some emergency care products) now offer a free service of listing training companies and their services or provide free links to training entity websites. Public & Community Events Attending public events is a great way to make a personal impression on future prospective clients that can lead to future sales in your community. Buy a booth at a trade show, speak about defibrillation at a local community group meeting or bring your AED to the local safety exposition at the mall or other sites in your community. Although it may seem to be costly and time consuming, attending public events is a great way to get your word out about you and your business. Strategic Alliances Another way to help grow your business is to form professional relationships with companies, organizations or individuals who provide related or synergistic products and services to your products and services. For example, developing an affiliation with a representatives or distributors of AED devices can lead to referrals for training and AED implementation services. Or you may “partner” with a hospital that’s interested in providing a community outreach program for CPR, First Aid or AED training. Persistence Whatever methods you choose to let potential customers know about you the key to effective sales and marketing is persistence and repetition. Your clients and potential clients have to see and hear from you often. Emergency medical preparedness is generally not their priority or any given day, and you have to be “in their face” on a regular basis to remind them of this important need and your ability to help them meet it. AED Implementation Issues The AED has ushered a new era into the health and safety training industry. Professional instructors now not only sell training programs, but also service equipment and machines and help maintain emergency readiness. Instructors and emergency care management specialist sell total solutions to sudden cardiac arrest AED Instructor Foundation. All rights reserved. 2002. 27 and other life threatening medical emergencies. With these solutions however, there is a requisite amount of technical expertise and operational detail necessary to run a successful program. Prescription As a class III medical device, an automated external defibrillator generally requires a physician’s order before it can be purchased and implemented. If you plan on being active in the AED market, you must affiliate with a physician or large AED medical control service to facilitate your AED prescriptions for worthy clients. Often a local occupational health physician will be interested in assisting you with this as it is in his or her best interests to become involved with local companies so that he/she can sell them physicals, health screenings, or other venues. Approach an occupational health practice locally and see how they feel about being involved in an AED program. Medical Direction Most states still require that AED’s placed in community settings function under the supervision and control of a physician. In these cases, a company physician or perhaps your affiliated doctor will be responsible for reviewing cases where the AED is used and in general making sure that the machine is being used properly. There are also now services that provide AED medical control on a national level – these services may assist you in making AED sales and placement simply by facilitating the medical control. EMS Interface Be sure to research your local AED laws thoroughly. Some of them require that local EMS be notified of AED placements, that the AED’s be registered with the county or other EMS authority, and/or that additional administrative requirements be followed. Even if there are no laws requiring you to do so, sending a letter to the local EMS agency about a public defibrillator placement is courteous, professional, and may result in additional business if the local EMS agency refers you to other organizations that are looking to implement such programs. Defibrillator Acquisition As a consultant you should make yourself part of the AED acquisition process. Selling AED’s yourself can be an excellent way to add a revenue stream to your operation. Or you can utilize the AED Instructor Foundation’s “PAD Support Program” to facilitate acquisition of an AED. If you do not want to “sell” AED’s, you should be affiliated with representatives of all the FDA-approved products that you like so that you can refer requests for machines. Besides the potential for a finder’s fee, an AED representative that you deal with can sometimes provide you with training leads for machines that he/she has sold. The AED salesperson-trainer relationship can be mutually beneficial. Plans and Protocols Corporate and industrial buyers expect written plans from their consultants. You should prepare a template for an AED program so that you can adjust it to individual clients. Your AED program should specify policies and procedures for using, maintaining, and training with your AED. It should also identify responsible parties for when there is a machine failure, when supplies need to be ordered, and/or for additional training when required. A critical part of an AED written program is a checklist of things to do is the machine is used on a patient. This should include whom to contact for additional supplies, event downloading or medical director notification. AED Instructor Foundation. All rights reserved. 2002. 28 Case Review As a consultant, you should be prepared to review any situations where the machine has been used on a real patient. In addition to the medical director’s involvement on the clinical side, your review of the situation can yield ideas for program improvement such as better access to the unit, additional units, more strategic placement, or security issues. Case review is an important service that most companies are unprepared to do for themselves. You should also speak to the responders about the case if possible, as they may be having significant feelings about the event that should be discussed. You should also be prepared to provide referrals to specialized Critical Incident Stress Debriefing (CISD) services or corporate Employee Assistance Programs (EAP) if needed and available. CONCLUSION The emergency care training industry has significant projected growth, largely fueled by the fairly new availability of AED’s. Frost and Sullivan have estimated the AED market in 2001 was $173 million dollars in machine sales alone. The expected growth rate for the industry is around 28% per year, leading to an estimated $600 million by 2006. This document was prepared as a guide to starting a training and consultant practice. It is intended as helpful assistance for individuals who wish to become involved in this burgeoning “cottage industry” and in the proper preparation of companies, communities and public places for optimal response to medical emergencies. This Guide is based on the experiences and combined expertise of seasoned instructors and consultants in this small but growing and important industry. It is only a primer to help get you started. Your ultimate success is dependent on your desire to succeed, your hard work and your commitment to reducing premature death and preventable disability in your community. We wish you great success in your endeavor to provide a much needed community service and to produce a fair and honest economic gain for yourself and your family. Good luck…but remember the words of Coach Vince Lombardi: “Luck is preparation taking advantage of an opportunity.” AED Instructor Foundation. All rights reserved. 2002. 29 APPENDIX I: Suggested Equipment List for a Health/Safety Training Agency. This list of suggested equipment is for a consultant who is not industry-specific and is training a group of 2-10 individuals. Some consultants need more or less materials based on client expectations. Maintain an inventory of two weeks supply of equipment. AUDIO VISUAL EQUIPMENT ESTIMATED COST AV set(s) from accrediting agency for all programs in the course list. $400 Portable VCR/TV $250 Manikins/Training Equipment Variable SUPPLIES ESTIMATED COST 3-4 removable face adult manikins $150 - $200 each 3-4 removable face child manikins 130 - $180 each 3-4 removable face infant manikins $100 - $200 each Additional faces & supplies $150 OPTION1 OPTION 2 COURSE EQUIPMENT ESTIMATED COST 10 individual student adult/child manikins $40 - 75 each 10 individual student infant manikins $35 - 100 each Additional supplies $150 2-3 AED Trainers $300 - $500 each 3-4 of each adult, infant, child bag-valve masks $13 - $25 each 10 Pocket Masks/Face Shields $5 - $20 each First Aid Kits/Bags with supplies for practice $15 - $20 each Student Supplies / Disposables Variable Cost Manuals for Students $4 - $20 each Miscellaneous (Training valves, alcohol wipes, etc.) $100 AED Instructor Foundation. All rights reserved. 2002. 30 APPENDIX II: Checklist for Establishing Your Business This checklist will help you identify the operational needs that need to be in place before beginning our training and sales operations. Physical Needs: ____ Phone line with answering system and business greeting. ____ Location for storage of records and paperwork. ____ Computer system for data collection, letter writing, and general communication. Administration Needs: ____ List of programs offered by agency. ____ Brochure and/or additional information about specific course offerings. ____ Business card(s). Certification Needs: ____ Instructorship through training system(s) of choice. ____ Established business identity with checking account. Networking Needs: ____ Relationship with 2-3 additional instructors who have accepted per diem work. ____ Referral points with local Sales Representatives for AED’s and other equipment. Vendor Needs: ____ Identified vendor for books and student materials. AED Instructor Foundation. All rights reserved. 2002. 31
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