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ASHRM CPHRM Exam Syllabus Topics:

SectionObjectives
Topic 1: Healthcare Risk Management Program Administration- Program development and governance
- Performance measurement and improvement
Topic 2: Healthcare Risk Management Foundations- Risk identification and assessment methods
- Risk mitigation strategies
- Principles of healthcare risk management
Topic 3: Claims and Litigation Management- Claims investigation and management processes
- Litigation support and documentation handling
Topic 4: Clinical and Patient Safety- Clinical risk reduction strategies
- Adverse event analysis and reporting
- Patient safety principles and frameworks
Topic 5: Legal, Regulatory, and Ethical Issues- Consent, confidentiality, and documentation standards
- Healthcare law and regulatory compliance
- Ethical considerations in healthcare risk management
Topic 6: Risk Financing and Insurance- Captive insurance and self-insurance models
- Risk financing mechanisms
- Insurance structures in healthcare

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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q91-Q96):

NEW QUESTION # 91
A hold-harmless agreement is an important component of which of the following aspects of a risk financing program?

Answer: C

Explanation:
Within Health Care Risk Management frameworks established by ASHRM and the American Hospital Association Certification Center, risk financing strategies include risk retention, risk transfer, and insurance mechanisms. A hold-harmless agreement is a contractual provision in which one party agrees to assume responsibility for certain liabilities and to protect another party from claims or losses arising from specified activities. This mechanism is a classic example of risk transfer.
Through hold-harmless or indemnification clauses, an organization shifts potential financial responsibility for loss to another party, often a contractor, vendor, or service provider. This contractual allocation of liability reduces the organization's exposure without necessarily purchasing insurance. It is therefore categorized under noninsurance risk transfer.
Risk retention, by contrast, involves assuming and financing losses internally, such as through self-insurance or deductibles. First-party liability insurance addresses losses sustained directly by the insured organization, while third-party liability insurance covers claims made by others against the organization. Although insurance is also a method of risk transfer, the specific instrument described in the question is a contractual transfer mechanism rather than an insurance product.
Accordingly, a hold-harmless agreement is most directly associated with risk transfer within a comprehensive risk financing program.


NEW QUESTION # 92
When conducting an investigation of a liability claim, which of the following steps should be included?
* providing the RCA to the insurance company
* determining the applicable standard of care
* assessing the applicable legal principles
* obtaining an incident report from the claimant

Answer: D

Explanation:
According to Health Care Risk Management standards established by ASHRM and the American Hospital Association Certification Center, investigation of a liability claim requires careful evaluation of both clinical and legal components. Determining the applicable standard of care is essential to assess whether the provider' s actions met accepted professional practice. This typically involves review of medical records, consultation with clinical experts, and comparison to established guidelines or customary practices within the specialty.
Assessing applicable legal principles is also critical. This includes analysis of duty, breach, causation, and damages, as well as jurisdiction-specific statutes of limitation, comparative negligence standards, and evidentiary considerations. Understanding the legal framework allows the risk manager to evaluate exposure and advise counsel appropriately.
Providing a root cause analysis to the insurance company may compromise privilege protections, depending on jurisdiction and policy structure. RCA documents are often protected under peer review or patient safety statutes and should not be disclosed without legal guidance. Obtaining an incident report from the claimant is not appropriate, as internal incident reports are generated by the organization and are not requested from claimants.
Claims and litigation objectives emphasize structured legal and clinical evaluation. Therefore, determining the standard of care and assessing applicable legal principles are required investigative steps.


NEW QUESTION # 93
Which of the following should prompt a risk manager to give notice to a malpractice carrier?

Answer: B

Explanation:
Under Health Care Risk Management principles established by ASHRM and the American Hospital Association Certification Center, timely notice to a malpractice carrier is a critical obligation, particularly under claims-made policies. A demand letter from a patient constitutes a clear assertion of liability and a request for compensation, which typically meets the definition of a claim under most malpractice insurance policies. Failure to notify the carrier promptly may jeopardize coverage.
A written medical record request from an attorney may signal potential litigation, but it does not necessarily constitute a claim unless accompanied by an allegation of wrongdoing or a demand for damages. An internal incident report is a risk management tool used for quality and safety improvement and does not itself trigger insurance notification requirements. Similarly, disclosure to a patient regarding an adverse event aligns with transparency practices but does not automatically represent a formal claim.
Risk management objectives emphasize understanding policy language, particularly definitions of claim and reporting requirements. Because a demand letter explicitly alleges harm and seeks compensation, it most clearly triggers the duty to notify the malpractice carrier to preserve coverage and initiate appropriate claims handling procedures.


NEW QUESTION # 94
Which of the following analyses is required as part of the sentinel event process of The Joint Commission?

Answer: A

Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, The Joint Commission's sentinel event process requires completion of a thorough root cause analysis and development of a corrective action plan. While various analytical tools such as fishbone diagrams, flowcharts, or Pareto charts may be used to assist in identifying contributing factors, these specific tools are not mandated.
The essential required component is a written action plan that identifies specific improvement steps, assigns responsibility, and includes measurable outcomes and timelines for implementation. The action plan must address root causes and system vulnerabilities, not merely individual performance issues. It should demonstrate how corrective actions will reduce the likelihood of recurrence and include monitoring mechanisms to evaluate effectiveness.
Fishbone diagrams and Pareto charts are optional tools used during analysis but are not explicitly required elements. Similarly, departmental flowcharts may support understanding of processes but are not mandated by The Joint Commission.
Clinical and patient safety objectives emphasize systematic investigation, leadership oversight, and documented improvement efforts following sentinel events. Therefore, a detailed action plan with implementation dates is the required analysis component within the sentinel event process.


NEW QUESTION # 95
When CPOE is implemented, there is almost always a decline in:

Answer: D

Explanation:
Computerized Provider Order Entry (CPOE) reduces medication errors primarily by eliminating illegible handwriting, standardizing order fields, and enabling decision support (allergy checks, dosing ranges, interactions). Evidence indicates CPOE can significantly reduce prescribing errors and improve patient safety, though it can also introduce new error types (selection errors, alert fatigue), requiring careful design and monitoring. From a risk management perspective, CPOE is a high-impact control that strengthens medication safety defenses at the "front end" of the medication-use process. Risk objectives include governance for order sets, usability testing, monitoring override patterns, and continuous training to prevent workarounds. Properly implemented, CPOE supports safer, more reliable care and reduces preventable adverse drug events, aligning with enterprise safety goals and regulatory expectations for medication management.


NEW QUESTION # 96
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