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>> Relevant CPHRM Questions <<
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NEW QUESTION # 80
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: A
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 # 81
An HMO advertises it is "the best" and its physicians can manage any illness/injury. A patient relies on this and is injured. The patient might sue the HMO for:
Answer: A
Explanation:
Marketing claims can create liability exposure when they reasonably induce reliance and the patient suffers harm. Depending on jurisdiction and facts, plaintiffs may allegeapparent agency(belief that physicians acted as the HMO's agents),vicarious liability, negligent credentialing, or negligent misrepresentation/consumer protection claims if statements are misleading. Risk management objectives include reviewing public claims for accuracy, ensuring marketing does not overpromise clinical capability, and aligning network adequacy and credentialing with representations. Clear disclosures about independent contractors may help but do not always defeat apparent agency claims. Controls include legal review of advertising, credentialing rigor, quality oversight, and complaint surveillance to detect mismatches between marketing and actual service capability.
NEW QUESTION # 82
Documentation that assists with defense of a malpractice claim
Answer: D
Explanation:
According to Health Care Risk Management principles outlined by ASHRM and the American Hospital Association Certification Center, high-quality clinical documentation is critical in defending malpractice claims. The medical record serves as the primary evidence of care provided and reflects whether the standard of care was met.
Documentation that clearly describes the provider's clinical decision-making process is particularly valuable in litigation. It demonstrates assessment findings, differential diagnoses, rationale for chosen interventions, informed consent discussions, and follow-up plans. Thorough documentation provides objective support for clinical judgments and establishes a defensible narrative of care.
Subjective or disparaging comments about the patient can undermine credibility and may be harmful in court.
Complete and timely documentation is essential; delayed or incomplete entries may suggest negligence or alteration. Additionally, documentation remains important regardless of when a claim arises, as statutes of limitation may allow claims to be filed years after the event, especially in cases involving minors or discovery rules.
Claims and litigation objectives emphasize accurate, objective, and contemporaneous recordkeeping to reduce liability exposure. Therefore, documentation that clearly outlines the provider's clinical reasoning best assists in defending a malpractice claim.
NEW QUESTION # 83
A 78-year-old patient in the ICU is unable to speak or swallow. The physician states that she is terminally ill and believes she lacks decision-making capacity. As such, he has deferred to her properly executed advance directive that clearly outlines her wishes for no life-prolonging treatment. The patient's three sons know of the directive, but insist that a PEG tube be placed to assist with feeding. The physician is opposed to placing the tube. The nurse calls the risk manager for advice. Which of the following should the risk manager advise?
Answer: A
Explanation:
Under Health Care Risk Management principles recognized by ASHRM and the American Hospital Association Certification Center, a properly executed advance directive carries legal authority when a patient lacks decision-making capacity. The physician has assessed that the patient is terminally ill and lacks capacity, triggering activation of the advance directive. If the directive clearly states refusal of life-prolonging treatment, including artificial nutrition and hydration, those wishes must be honored in accordance with state law and the Patient Self-Determination Act framework.
Patient autonomy is a foundational ethical and legal principle in health care. Once capacity is lost, previously expressed wishes through a valid advance directive govern care decisions. Family members do not have authority to override a valid directive unless legal defects or ambiguity exist. Their disagreement does not negate the patient's documented preferences.
Although ethics consultation can be helpful in managing conflict, the directive here is described as properly executed and clear. Additional determination of capacity is unnecessary because the physician has already made that assessment.
Risk management objectives emphasize compliance with advance directive statutes, respect for patient autonomy, and reduction of liability through adherence to documented patient wishes. Therefore, the appropriate advice is to support the physician in honoring the advance directive.
NEW QUESTION # 84
Which of the following analyses is required as part of the sentinel event process of The Joint Commission?
Answer: B
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 # 85
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