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NEW QUESTION # 81
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 # 82
A patient has been declared brain dead as a result of injuries sustained during a criminal act. His driver's license states that he is an organ donor. The attending physician is planning to remove the life-support equipment. A risk manager should recommend
Answer: B
Explanation:
According to Health Care Risk Management standards established by ASHRM and the American Hospital Association Certification Center, deaths resulting from criminal acts fall under medico-legal jurisdiction and are typically subject to coroner or medical examiner review. Even when a patient is a documented organ donor, as indicated on a driver's license under the Uniform Anatomical Gift Act framework, the circumstances of death may require legal investigation.
When a death is associated with trauma from a criminal act, it is generally considered a reportable death. The medical examiner or coroner has statutory authority to determine whether an autopsy is required and to ensure preservation of forensic evidence. Organ procurement activities must not interfere with legal investigation obligations. Therefore, prior to organ retrieval or withdrawal of life support, the appropriate legal authorities must be notified.
While honoring the patient's documented donation wishes is important, compliance with state statutes governing reportable deaths and forensic investigations takes precedence. The family's wishes do not override a valid donor designation, but coordination must occur within the legal framework.
Thus, the most appropriate action for the risk manager is to ensure that authorities are notified to determine autopsy requirements before proceeding.
NEW QUESTION # 83
What are risk treatment strategies?
Answer: D
Explanation:
Core risk treatment strategies includeavoidance(stop the activity),reduction/mitigation(controls that reduce likelihood/severity),retention(accept risk within appetite and fund losses via reserves/self-insurance), and transfer(contracts/insurance shifting financial consequences). In healthcare, the highest priority is often mitigation for patient safety risks (standardization, technology, training), with financing mechanisms ensuring the organization can absorb residual loss without destabilizing operations. ERM aligns these strategies to enterprise objectives so leadership invests in the best mix of prevention and financing.
NEW QUESTION # 84
What are the four elements of the SBAR situational briefing model?
Answer: C
Explanation:
SBAR is a standardized communication framework used to reduce preventable harm caused by incomplete, unclear, or delayed clinical communication-especially during handoffs, escalations, and urgent updates. The four elements areSituation(what is happening now),Background(clinical context and relevant history), Assessment(what you think the problem is based on data), andRecommendation(what you need/request as the next step). By forcing concise structure, SBAR improves shared situational awareness, supports early recognition of deterioration, and reduces ambiguity ("hinting and hoping"). From a risk management standpoint, SBAR strengthens frontline reliability, decreases communication-related sentinel events, and supports defensible care by demonstrating a consistent escalation process. It also aligns with patient safety objectives: clearer teamwork, faster response to clinical changes, and fewer omissions during transitions of care.
NEW QUESTION # 85
Aside from clinical risk exposures, which of the following should be evaluated as part of a risk assessment concerning telemedicine?
Answer: D
Explanation:
According to Health Care Risk Management standards outlined by ASHRM and the American Hospital Association Certification Center, telemedicine risk assessment must extend beyond clinical quality of care to include operational risks. Operational considerations encompass technology infrastructure reliability, cybersecurity protections, credentialing and privileging of providers across state lines, licensing compliance, documentation workflows, data storage, and continuity planning for system outages.
Telemedicine platforms rely heavily on secure networks, interoperability with electronic health records, and protection of protected health information. Operational failures such as system downtime, inadequate bandwidth, or insufficient training can disrupt care delivery and increase liability exposure. Additionally, compliance with regulatory requirements regarding interstate practice and reimbursement policies falls within operational risk management.
Behavioral and public awareness considerations may influence patient engagement but are not primary risk assessment categories. Financial risks are relevant in enterprise risk management; however, the question specifically contrasts clinical risk exposures with other telemedicine-related risks, making operational risk the most directly applicable.
Health Care Operations objectives emphasize comprehensive evaluation of technological, regulatory, and workflow factors in emerging service models. Therefore, operational risks should be evaluated alongside clinical exposures when assessing telemedicine programs.
NEW QUESTION # 86
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