Read Case Study Fifty-Three: Is Whispering Willows Nursing ✓ Solved

Read Case Study Fifty-Three: Is Whispering Willows Nursing H

Read Case Study Fifty-Three: Is Whispering Willows Nursing Home Prepared for a Disaster? Evaluate the case study using the following format: Background Statement: summarize the scenario in your own words, describe the organization, setting, situation, who is involved, and who decides what. Identify the major problems and secondary issues; analyze causes and effects. Declare your role (e.g., chief administrator or outside consultant) and justify the choice, noting advantages and disadvantages. Recognize strengths and weaknesses of the organization related to the major problem, including managerial and diversity-related factors. Propose two to three alternative solutions with pros and cons, recommend a feasible strategy stating what should be done, why, how, and by whom, and include measurable goals. Describe an evaluation plan to assess progress toward goals. Support the evaluation with at least two scholarly/peer-reviewed articles and cite sources in APA format.

Paper For Above Instructions

Background Statement

Whispering Willows Nursing Home is preparing to test its All-Hazards Continuity of Operations Plan (COOP) through a live, real-time disaster exercise requested by the nursing home administrator, Bob. The facility houses vulnerable older adults with varying care needs, is managed by an administrative team, and relies on nursing, support, and ancillary staff for daily operations. The proposed activity is a high-fidelity, experiential drill intended to reveal operational gaps in evacuation, clinical continuity, communications, and supply chain resilience. Key stakeholders include the administrator, nurse managers, frontline staff, residents and families, and external partners (EMS, local emergency management). The central objective is to evaluate whether the organization can sustain essential functions and protect residents under an “all hazards” scenario.

Major Problems and Secondary Issues

The major problem is inadequate validated preparedness for a full-scale all-hazards incident that threatens resident safety and continuity of care. Contributing secondary issues include inconsistent staff training on COOP protocols, unclear decision-making authority under crisis conditions, insufficient redundancy for critical supplies and power, and limited validated communication pathways with external partners. Secondary issues such as staff turnover, documentation lapses, and lack of culturally appropriate emergency communication may escalate into major failures during a real disaster (Dosa et al., 2007; CDC, 2015). The causes are both systemic (limited institutional investment in drills and resources) and operational (unclear roles, inconsistent policies). Effects include risk to resident safety, regulatory noncompliance, potential reputational harm, and legal exposure if evacuations or clinical care falter during an actual event (CMS, 2016).

Role Declaration

I will address the problem as an outside emergency-preparedness consultant retained by Whispering Willows. This role is justified because an external consultant brings an objective perspective, experience across multiple facilities, and specialized knowledge of COOP design and exercise evaluation—valuable for designing a rigorous live exercise and ensuring regulatory alignment (FEMA, 2018). Advantages include impartial gap analysis, access to best practices, and ability to facilitate multi-agency coordination. Disadvantages include possible resistance from staff who may view external review as punitive and reduced intimate knowledge of facility culture; these can be mitigated by early staff engagement and collaborative planning.

Organizational Strengths and Weaknesses

Strengths: Whispering Willows likely has an administrative commitment to readiness (administrator-initiated exercise), an established COOP document, and existing relationships with local EMS. Managerial strengths may include delegated authority for daily operations and basic staff competencies in ADLs and medication administration. Weaknesses: probable gaps include insufficient frequency/intensity of drills, absence of validated surge staffing plans, inadequate supply and power redundancy, and limited culturally and linguistically appropriate communication mechanisms for diverse residents (Gouin & Brown, 2019). Managerial-level weaknesses may manifest as unclear succession planning, poor interdepartmental coordination during crises, and limited budget allocation for emergency preparedness training.

Alternatives and Recommendation

Three feasible alternatives were considered:

1. Tabletop Exercise Followed by Hotwash and Plan Revision: Low disruption; identifies policy gaps via discussion. Pros: safe, cost-effective, engages leadership. Cons: may not reveal operational or human-factor failures (Smith & Perrin, 2014).
2. Full-Scale Live Exercise (Evacuation/COOP Activation): High realism; tests logistics, communications, and clinical continuity. Pros: reveals real-world constraints and training deficits. Cons: resource intensive, risk of resident/staff stress if poorly managed (Thomas et al., 2013).
3. Hybrid Progressive Exercise Series: Begin with tabletop, advance to functional drills, and culminate in a targeted live exercise for highest-risk functions. Pros: balances learning curve, minimizes risk, builds staff competency progressively. Cons: longer timeline and sustained resource commitment.

Recommendation: Implement the hybrid progressive exercise series. This approach leverages the benefits of incremental learning while minimizing resident risk and operational disruption. It also creates measurable milestones for improvement and builds staff confidence prior to any large-scale live event (Harrald & Jefferson, 2011).

Implementation Plan: Who, How, and Why

Phase 1 (Month 1–2): Tabletop exercise with leadership and department leads to validate COOP roles, decision authority, and communications. Responsible: Administrator, consultant, department heads. Deliverables: revised COOP roles matrix, updated contact lists.

Phase 2 (Month 3–4): Functional drills testing communications, backup power activation, medication continuity, and resident movement protocols. Responsible: Nurse managers, maintenance, pharmacy liaison, consultant. Deliverables: drill logs, time-to-task metrics, corrective action plans.

Phase 3 (Month 5–6): Targeted live exercise (short-duration, controlled) simulating a realistic hazard (e.g., limited evacuation due to fire or flooding). Responsible: Administrator, external EMS, consultant. Deliverables: after-action report (AAR), updated COOP, staff training schedule.

Why: Phased progression allows incremental learning, reduces resident harm risk, and builds validated capability across essential functions (FEMA, 2018; The Joint Commission, 2017).

Measurable Goals and Evaluation Plan

Measurable goals:

• Reduce average resident relocation time during drill scenarios by 30% within 6 months (baseline measured during functional drill).
• Achieve 90% staff completion of COOP role training and competency checks within 90 days of rollout.
• Verify backup power activation and supply redundancy sufficient for 72 hours of sustained operations during drills (100% activation success).
• Establish verified communications with EMS and local emergency management within 15 minutes in 95% of drills.

Evaluation plan: Use pre- and post-drill metrics, AARs, staff competency assessments, and compliance checks against CMS emergency preparedness requirements (CMS, 2016). Data collection includes timed tasks, error logs, staff surveys, resident outcome indicators, and documentation audits. Progress will be reviewed monthly by a preparedness steering committee that includes leadership, clinical, and support representatives and reports to the administrator. Key performance indicators (KPIs) will be published internally and used to adjust training and resource allocation (CDC, 2015).

Conclusion

Whispering Willows has taken an important step by pursuing a real-time COOP test. However, moving directly to a full-scale live disaster exercise without progressive validation risks resident safety and may fail to isolate systemic weaknesses. A consultant-led, phased hybrid exercise plan—starting with tabletop, advancing through functional drills, and culminating in a targeted live exercise—provides the best balance of realism, safety, and organizational learning. Measurable goals and a rigorous evaluation plan aligned with regulatory guidance and peer-reviewed best practices will ensure that the facility meaningfully improves preparedness and protects residents during future all-hazards events (FEMA, 2018; Dosa et al., 2007).

References

• Centers for Disease Control and Prevention. (2015). Emergency preparedness for long-term care facilities. Retrieved from https://www.cdc.gov/longtermcare/pdfs
• Centers for Medicare & Medicaid Services. (2016). Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. Retrieved from https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals
• Federal Emergency Management Agency. (2018). Continuity Guidance Circular. FEMA.
• The Joint Commission. (2017). Emergency Management Standards. The Joint Commission.
• Dosa, D. M., Hyer, K., Brown, L. M., & Tucker, R. (2007). Nursing home evacuation challenges during disasters: Lessons from Hurricane experiences. Journal of the American Geriatrics Society, 55(10), 1663–1668.
• Thomas, K. S., Dosa, D., & Hyer, K. (2013). Nursing home preparedness and response during disasters. Journal of Applied Gerontology, 32(4), 435–452.
• Harrald, J. R., & Jefferson, T. (2011). All-hazards approaches to health facility preparedness. International Journal of Disaster Risk Reduction, 1(2), 66–74.
• Smith, B. J., & Perrin, K. M. (2014). Exercise-based disaster preparedness in long-term care settings. Journal of Nursing Administration, 44(6), 321–327.
• Gouin, S., & Brown, R. (2019). Disaster preparedness in nursing homes: A systematic review. Journal of Aging & Social Policy, 31(3), 200–220.
• Institute of Medicine. (2012). Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. National Academies Press.