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AED Macroeconomics 101: A Shifting Demand Curve

Unlike many other job skills, AED/CPR capabilities have universal utility and can be used outside of the workplace to save others, such as family members.

There are a number of stereotypes surrounding cardiac arrest. Unfortunately, many of these are dangerously inaccurate. Often, people view cardiac arrest to be a "geriatric" issue. However, numerous studies reveal the flaw in this assumption. A recently published study by Marijon, et al., showed a mean age of 53 for cardiac arrest victims over a 10-year period. As a further supporting anecdote, cardiac arrest occurs in approximately one out of every 70 U.S. high schools each year. Clearly, cardiac arrest is an issue that transcends the "aged" population.

Interestingly, the Marijon study also found that only 5 percent of the victims experienced cardiac arrest while exercising. While this may provide comfort in re-invigorating your New Year's resolution (and it should!), the key point is that 95 percent of the time, cardiac arrest occurs while people are doing everyday tasks in everyday locations such as offices, factories, stores, and homes.

While these statistics obviously underscore the need for safety professionals to consider the risk of cardiac arrest in protecting their sites, other trends in employee and customer expectations are increasing the importance and immediacy of this consideration.

Many are now accustomed to seeing Automated External Defibrillators (AEDs) in airports. Appreciating this, it is not surprising that a recent Harris Interactive survey of the consumer public revealed that nearly 80 percent of people expect to find AEDs in airports. What may be surprising to you are the results revealed by the remainder of the survey: Roughly, three out of every five respondents expect to find AEDs in locations such as factories, hotels, offices, and shopping malls. Further, approximately 40 percent of survey participants anticipate AEDs being present at sites such as retail stores, restaurants, and banks.

While these expectations are meaningful in their own right, perhaps more telling are the increases in these expectations compared to the results from a similar study 14 months prior. In this short span of time, expectations rose across all location types, with more than half of the site categories posting double-digit increases. Expectations for AED presence in the workplace were up 19 perecent. Some of the other notable increases were for venues such as banks (+33 percent), retail stores (+21 percent), and restaurants (+18 percent). These trends are meaningful in isolation; however, the latter categories are particularly significant in view of their consumer-facing characteristics. Simply, as people become more accustomed to the presence of AEDs in everyday locations-- such as the stores in which they shop--their anticipation of finding AEDs in other locations seems to rise, as well.

A Virtuous Circle
These changing perspectives on AEDs are fueled by an interesting confluence of factors. In view of cardiac arrest’s status as the leading single cause of death in the United States, organizations such as the American Heart Association have rightfully expended considerable effort to raise the public's knowledge about cardiac arrest and its treatment options. These efforts overlay with a changing health care landscape (Affordable Care Act emphasis on outcomes, the aging population, prevalence of obesity, etc.) that is also driving higher awareness levels.

Concurrently, as more people become aware of the cardiac arrest problem, falling AED prices and new technology and tools for AED program management are making it easier for organizations to install and maintain preparations. The result is something of a virtuous circle whereby increasing demand is spurring greater AED adoption and heightened adoption rates are driving greater demand.

Clearly, these factors are relevant to employee morale, site safety, and other issues more specific to the workplace. Additionally, there are broader implications as expectations (and lower barriers to adoption) can have a direct bearing on common-law obligations. While the number of cardiac arrest-related lawsuits remains modest compared to the high volume categories of workers' compensation and automobiles, there have been some high-profile cases over the past several years that draw historical duty of care boundaries into question. Now, even higher public expectations will elicit more visceral reactions to circumstances where adequate protections were not in place (and add to the plaintiffs' bar appetite for taking on cases in the sector).

As safety professionals meet these heightened employee and customer expectations and protect against growing liability, it is clearly important that sound frameworks are used--both in initial AED program implementation and ongoing management and enhancement. Doing so places new and altered operational requirements upon organizations.

While not a panacea, thoughtful planning around the initial implementation and ongoing support requirements will substantially reduce the prospective management load. Fortunately, a number of technological advances, including compliance-promoting mobile applications, are also now available to minimize time and resource requirements while improving program performance.

Traditionally, training currency has proven to be one of the biggest challenges for adopters of AED programs, and it is vital to consider the parameters of your training approach at the outset. While AED/CPR training itself is not difficult, without forethought, logistics can otherwise become daunting, particularly for organizations with high employee turnover.

In this process, common sense can go a long way. Before offering training, it is very useful to consider whom you would like to train, because some groups may make better candidates than others. Certainly, focusing on segments with lower turnover is helpful, but shift schedules, vacation patterns, and employee locations also vary by organization. It is important to select an approach that fits best within your framework. Equally, it is helpful to explain to candidates both what would be expected of them and the ancillary benefits that AED/CPR training can provide.

Perhaps the most notable of these additional benefits is the portability of the training. Unlike many other job skills, AED / CPR capabilities have universal utility and can be used outside of the workplace to save others, such as family members.

Training Options
As pre-planning can alleviate a variety of training issues, there are also options for the approach to the training itself. There are now multiple mechanisms and formats to train employees while also conforming to standards required for state-level Good Samaritan requirements. Certainly, traditional in-person formats can work well, but depending on the nature of your organization, other avenues may present more practical options.

For organizations with large numbers of trainees at specific locations, a "train the trainer" approach can be both operationally effective and cost effective. Also, many providers now offer blended alternatives, where a portion of the training is completed in advance, with an in-person assessment provided afterward. Finally, pure online training can be used in isolation or as a supplement to other mechanisms.

A proactive ability to address change is a key tenet of a high-quality safety and risk management program. Nevertheless, all organizations have their own unique characteristics. Like other initiatives, in order to meet the new demands and expectations regarding on-site AEDs, what is ultimately most important is selecting the approach that will work best for your organization.

This article originally appeared in the June 2015 issue of Occupational Health & Safety.

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