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ASHRM CPHRM 認定試験の出題範囲:

トピック出題範囲
トピック 1
  • Clinical
  • Patient Safety: This domain focuses on improving patient safety by promoting a safety culture, managing incident reporting, educating staff and patients, addressing ethical concerns, and implementing corrective actions to reduce risks and prevent harm.
トピック 2
  • Claims and Litigation: This domain focuses on handling potential claims and legal cases, including claim reporting, litigation support, legal documentation management, and analyzing claims data to understand risk exposure.
トピック 3
  • Legal and Regulatory: This domain focuses on ensuring compliance with healthcare laws and regulations, protecting patient information, managing reporting requirements, and supporting accreditation and regulatory responses.
トピック 4
  • Healthcare Operations: This domain involves managing operational risk activities such as conducting risk assessments, developing policies, coordinating risk programs, supervising staff, and supporting patient safety initiatives.
トピック 5
  • Risk Financing: This domain covers managing financial risks through insurance programs, claims coordination, loss analysis, and developing strategies to reduce financial exposure.

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ASHRM Certified Professional in Health Care Risk Management (CPHRM) 認定 CPHRM 試験問題 (Q89-Q94):

質問 # 89
An organization's chief of orthopedics has scheduled an implant of a new artificial hip for the next day. The chief developed the artificial hip while working as a consultant for a medical device company. The device has not yet been approved by the FDA or the Institutional Review Board. The risk manager's best immediate course of action is to

正解:C

解説:
Under Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, the implantation of a medical device that lacks FDA approval and Institutional Review Board oversight presents significant legal and regulatory violations. Use of an unapproved device outside of an approved investigational protocol may violate federal regulations governing human subject research and medical device approval processes.
The risk manager's primary responsibility is to immediately mitigate regulatory and liability exposure.
Because the procedure is scheduled for the next day, urgent intervention is required. Contacting the FDA would not resolve the immediate risk. Verifying informed consent is insufficient, as patient consent cannot legitimize use of an unapproved device outside regulatory pathways. Calling a special IRB meeting would not retroactively authorize an unapproved device without appropriate investigational device exemption processes.
Escalating the issue to the chief of surgery to halt or cancel the procedure is the most appropriate immediate step. This ensures that organizational leadership addresses the compliance violation before patient harm occurs. Risk management objectives emphasize proactive prevention of regulatory breaches, protection of patient safety, and preservation of institutional integrity. Therefore, stopping the procedure is the correct and immediate action.


質問 # 90
An employer is not required to offer a reasonable accommodation to a job applicant with a qualified disability unless

正解:C

解説:
Under Health Care Risk Management principles aligned with ASHRM and the American Hospital Association Certification Center, compliance with the Americans with Disabilities Act ADA requires employers to provide reasonable accommodations to qualified individuals with disabilities. However, the obligation to provide accommodation is generally triggered when the applicant or employee makes the employer aware of the need for accommodation.
The interactive process required by the ADA begins once the applicant requests an accommodation or discloses a need related to a disability. Employers are not required to speculate about potential disabilities or initiate accommodations without notice. While documentation may be requested to verify the disability in certain circumstances, proof is not the triggering requirement. Instead, the request itself initiates the employer' s duty to engage in good faith discussion to determine reasonable accommodation.
Withholding accommodation that creates an unsafe condition may raise separate workplace safety concerns, but that is not the threshold requirement under the ADA. Similarly, an employer's recognition alone does not automatically impose an obligation absent a request or clear disclosure.
Legal and regulatory objectives emphasize proper documentation, consistent application of ADA standards, and engagement in the interactive process once accommodation is requested. Therefore, the employer's duty arises when the applicant requests the accommodation.


質問 # 91
An appropriate way to complete the verification read-back of a complete order, as required by The Joint Commission National Patient Safety Goals, is to have the person receiving the order

正解:A

解説:
According to Health Care Risk Management standards supported by ASHRM and The Joint Commission National Patient Safety Goals, the read-back process is designed to ensure accurate communication of verbal or telephone orders. The correct process requires the person receiving the order to first write down the complete order and then read it back to the prescribing practitioner for verification.
Writing the order down before reading it back reduces reliance on memory and decreases the risk of omission or transcription errors. The practitioner who gave the order must then confirm that the read-back is accurate.
This closed-loop communication process enhances patient safety and reduces medication and treatment errors associated with miscommunication.
Immediately repeating the information without documenting it does not meet the full verification requirement, as the written record must be confirmed. A witness is not required under the standard. Documenting the date and time is necessary for proper charting but does not constitute completion of the read-back verification itself.
Clinical and patient safety objectives emphasize clear, structured communication processes. Therefore, writing the information down before reading it back is the appropriate method to complete the verification process.


質問 # 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

正解:C

解説:
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.


質問 # 93
A 22-year-old man has been treated at a hospital for a psychiatric condition. His mother requests that a copy of the patient's medical record be released to her. The risk manager's advice to the medical records department should be to

正解:C


質問 # 94
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