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| Section | Weight | Objectives |
|---|---|---|
| Healthcare Operations | 20% | - Evaluate operational risk controls - Address workplace violence and safety - Identify operational risks in healthcare settings - Manage emergency preparedness and response - Implement risk management in clinical operations |
| Claims and Litigation | 20% | - Implement claims prevention strategies - Coordinate litigation support and defense - Evaluate litigation outcomes and lessons learned - Analyze claims data for risk patterns - Manage claims processes and documentation |
| Clinical/Patient Safety | 25% | - Assess patient safety state and staff awareness - Implement patient safety programs and interventions - Analyze clinical data to identify risks and trends - Evaluate effectiveness of patient safety initiatives - Collaborate on proactive safety initiatives (FMEA, RCA, Safety Culture/Just Culture) |
| Legal and Regulatory | 20% | - Manage legal risks and liabilities - Interpret healthcare laws and regulations - Ensure compliance with regulatory requirements - Analyze legal trends and precedents - Develop policies for legal compliance |
| Risk Financing | 15% | - Identify and analyze risk financing options - Evaluate insurance programs and coverage - Analyze risk transfer mechanisms - Develop risk financing strategies - Manage self-insurance and captive programs |
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問題 #84
If there is no OSHA standard for a given potential health hazard, OSHA may:
答案：D
解題說明：
OSHA can cite employers under theGeneral Duty Clausewhen a recognized serious hazard exists and no specific standard applies. Risk management objectives require proactive hazard identification and controls even when regulations are not prescriptive: risk assessments, engineering controls where feasible, administrative controls (policies, training), and PPE as a final layer. In healthcare, this is relevant for emerging hazards (novel chemical exposures, workplace violence risks, certain ergonomic hazards) where specific standards may be limited. Maintaining documentation of hazard recognition and mitigation is essential for defensibility during inspections and for staff safety outcomes.
問題 #85
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
答案：B
解題說明：
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, a 22-year-old patient is a legal adult and retains full rights to privacy and control over disclosure of protected health information under HIPAA and applicable state confidentiality laws. Psychiatric records are subject to heightened confidentiality protections in many jurisdictions.
Absent a court order or legal guardianship determination, a parent does not have automatic access to an adult child's medical records. Therefore, before releasing any information, the organization must verify that the patient has executed a valid, specific authorization for release of information that complies with HIPAA requirements. The authorization must clearly identify the recipient, the information to be disclosed, and be properly signed and dated.
Consulting legal counsel or a treating psychiatrist does not substitute for proper authorization. Similarly, requesting guardianship documentation would only be appropriate if the mother asserts legal guardianship status; however, in the absence of such documentation, release cannot occur.
Legal and regulatory objectives emphasize strict adherence to privacy laws, protection of psychiatric records, and proper authorization procedures. Therefore, verification of a signed release of information from the patient is required before disclosure.
問題 #86
A patient who has suffered a stroke is aphasic and unable to swallow. The physician would like to place a PEG tube for feeding. The patient is considered incapacitated and his wife consents to the treatment. The patient's adult children do not. The wife and oldest daughter each present a power of attorney document identifying them as the designated decision makers. To support the ethical principle of patient autonomy, which of the following should the risk manager recommend?
答案：C
解題說明：
Under Health Care Risk Management principles supported by ASHRM and the American Hospital Association Certification Center, patient autonomy is upheld by honoring valid advance directives and durable powers of attorney for healthcare. When multiple documents are presented that designate different decision makers, the most recent properly executed document typically supersedes earlier versions, unless state law provides otherwise.
Durable powers of attorney for healthcare may be revoked or replaced by executing a newer document.
Therefore, determining the effective document requires reviewing execution dates and ensuring validity under applicable state statutes, including witnessing and notarization requirements. The document with the more recent date generally reflects the patient's latest expressed wishes and controls decision-making authority.
Referring immediately to an ethics committee may be appropriate in unresolved value conflicts, but first establishing legal authority is essential. Asking the family to resolve the dispute independently delays necessary medical decisions and does not clarify legal standing. Selecting the older document would contradict the principle that later directives replace earlier ones.
Legal and regulatory objectives emphasize verification of surrogate authority, compliance with state advance directive laws, and protection of patient autonomy. Therefore, the risk manager should confirm which document is most recent and legally valid.
問題 #87
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:
答案：D
解題說明：
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.
問題 #88
When CPOE is implemented, there is almost always a decline in:
答案：A
解題說明：
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.
問題 #89
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