1. business and industrial

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
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APPENDIX I: Suggested Equipment List for a Health/Safety Training Agency
APPENDIX II: Checklist for Establishing Your Business
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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 (jsmith@smithconsulting.com ). Be weary of using email addresses from
free email services (jsmith@yahoo.com ) for business purposes – consumers tend
to associate them with a lack of resources on your end.
AED Instructor Foundation. All rights reserved. 2002.
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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
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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
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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:
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•
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
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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.
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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.
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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.
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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
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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
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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.
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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
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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
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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.
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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
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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.
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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.”
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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
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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.
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