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NEW QUESTION # 49
Root Cause Analyses most often reveal that mistakes are a result of:
Answer: A
Explanation:
RCA and systems safety models (e.g., Swiss Cheese) emphasize that adverse events typically requiremultiple contributing factors-small process breakdowns, latent conditions, and active failures-to align. This is why focusing only on the last person who touched the patient ("sharp end blame") rarely prevents recurrence. Risk management objectives are to identify and strengthen defenses: policies, training, equipment design, staffing models, communication standards, and redundancy where needed. A series-of-events understanding enables targeted corrective actions (forcing functions, standardization, automation with safeguards, independent double checks for high-alert processes). It also supports just culture: accountability is preserved for reckless behavior, but most improvement comes from redesigning systems that make errors more likely. This approach improves reliability, reduces repeat harm, and provides defensible evidence of organizational learning and corrective action.
NEW QUESTION # 50
A hospital is a defendant in a recently filed lawsuit involving a child with seizures and flaccid paresis, allegedly arising from negligent care during delivery 10 years ago. The plaintiff is seeking $10 million. At the time of the alleged negligence, the hospital had first dollar coverage through a commercial carrier.
Which of the following steps should the risk manager take to determine coverage before discussion with the hospital CEO and CFO?
* Review the current policy and the policy in effect for the year the delivery occurred.
* Determine whether the applicable policy is occurrence or claims made.
* Identify co-defendants insurance coverage.
* Discuss the coverage issues with the defense lawyer.
Answer: D
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, determining coverage requires careful review of the applicable insurance policies and policy structure. Because the alleged negligence occurred 10 years earlier, the risk manager must first review both the current policy and the policy in effect at the time of the delivery. Coverage depends on the specific policy terms, limits, endorsements, and retroactive dates applicable during the relevant policy period.
It is also critical to determine whether the policy is written on an occurrence or claims-made basis. Under an occurrence policy, coverage is triggered by the date of the incident, regardless of when the claim is filed.
Under a claims-made policy, coverage depends on when the claim was reported and whether appropriate tail or extended reporting coverage exists.
Identifying co-defendants' coverage may be relevant to contribution or indemnification but does not determine the hospital's own coverage. Discussion with defense counsel may assist in strategy but should follow preliminary internal coverage analysis.
Risk financing objectives emphasize accurate policy review and understanding of trigger mechanisms before executive discussions. Therefore, reviewing the relevant policies and determining policy type are essential first steps.
NEW QUESTION # 51
The source of many medication errors is:
Answer: B
Explanation:
Verbal/telephone orders are widely recognized aserror-pronebecause they can be misheard, misunderstood, or transcribed incorrectly-especially with sound-alike drug names, confusing numerals (15 vs 50), background noise, accents, and interruptions. ISMP and patient safety advisories recommend minimizing verbal orders whenever possible and using safeguards such as read-back/confirm-back, spelling drug names, stating digits individually, and documenting promptly. Risk management objectives include reducing reliance on memory and imperfect communication by prioritizing written or electronic orders (CPOE), standardizing when verbal orders are permitted (true emergencies), and auditing compliance to prevent unsafe normalization. Because medication errors can cause severe harm, controlling verbal order risk is a high-yield safety intervention and improves legal defensibility by aligning practice with recognized safety recommendations.
NEW QUESTION # 52
People make fewer errors when:
Answer: B
Explanation:
Team-based care reduces errors by improving communication, cross-monitoring, workload distribution, and escalation when risk increases. TeamSTEPPS and related patient safety evidence show teamwork training can improve safety culture and reduce clinical error rates by creating predictable behaviors-briefs, huddles, check-backs, and mutual support. From a risk management standpoint, teamwork is a high-leverage control because many serious adverse events involve coordination failures (handoffs, unclear ownership, missed deterioration). Effective teams also reduce "single-point-of-failure" risk; when one clinician misses something, another can catch it. Organizations operationalize this through standardized communication (SBAR), structured handoffs, simulation, and leadership support for psychological safety so staff speak up.
Team functioning is therefore not "soft skill"-it is a measurable safety barrier that reduces preventable harm and strengthens reliability in complex, high-acuity environments.
NEW QUESTION # 53
What is one advantage of avoluntaryerror reporting system over amandatoryerror reporting system?
Answer: B
Explanation:
Voluntary reporting systems often generatemore reports, especially ofnear-misses and low-harm events, because staff perceive less punitive risk and greater learning value. This is crucial for proactive risk management: near-misses expose weak signals and system vulnerabilities before a patient is harmed. A robust voluntary culture supports a "just culture" approach-encouraging reporting while still holding people accountable for reckless behavior. Compared with mandatory systems (typically limited to defined serious events), voluntary systems improve the organization's ability to identify patterns (communication failures, workflow traps, labeling issues, staffing risks), prioritize interventions, and measure improvement over time.
Risk management objectives include earlier hazard detection, better trend analysis, and stronger safety culture. To maximize effectiveness, leadership must provide feedback loops ("you reported, we improved"), protect confidentiality where permitted, and couple reporting with structured analysis (RCA/FMEA). While voluntary reporting does not automatically confer legal privilege, it is a foundational learning system in high- reliability healthcare operations.
NEW QUESTION # 54
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