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NEW QUESTION # 44
Who are most likelynotto report errors in typical incident reporting systems?
Answer: A
Explanation:
Multiple studies showphysicians report fewer incidentsthan nurses and other hospital staff in many voluntary reporting systems, influenced by cultural norms, fear of blame, time constraints, and preference to manage issues "in-house." This matters because underreporting distorts risk signals: leadership may miss trends in diagnostic delays, handoff failures, and near-misses that physicians uniquely observe. Risk management objectives therefore focus on reducing barriers: simplifying reporting, enabling quick mobile submissions, emphasizing psychological safety, and providing credible feedback that reporting leads to improvement (not punishment). Another proven strategy is integrating reporting into professional practice expectations and aligning medical leadership with "just culture" principles. Increasing physician reporting improves system learning, strengthens peer review insight, and supports defensibility by showing hazards were identified and addressed.
NEW QUESTION # 45
If no specific OSHA standard applies to a given potential health hazard, then
Answer: D
Explanation:
According to Health Care Risk Management standards outlined by ASHRM and the American Hospital Association Certification Center, the Occupational Safety and Health Act includes a provision known as the General Duty Clause. This clause requires employers to furnish a workplace free from recognized hazards that are causing or are likely to cause death or serious physical harm, even when no specific OSHA standard addresses the hazard.
The General Duty Clause grants OSHA authority to cite employers for unsafe conditions not explicitly covered by a detailed regulation. To issue a citation under this clause, OSHA must demonstrate that a recognized hazard exists, that the hazard poses a risk of serious harm, and that feasible methods exist to correct or mitigate the hazard.
Therefore, OSHA retains enforcement authority even in the absence of a specific standard. The agency's jurisdiction does not disappear simply because no detailed regulation addresses the particular risk.
Legal and regulatory objectives in healthcare risk management emphasize maintaining compliance with federal occupational safety laws and proactively identifying workplace hazards. Accordingly, OSHA may govern the hazard under the General Duty Clause when no specific standard applies.
NEW QUESTION # 46
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: B
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 # 47
A claims manager needs to open a loss reserve and perform an investigation of an event. They review the patient demographics, the nature and extent of the injury, and other liability factors. Which of the following would be helpful to the claims manager in determining a loss reserve?
Answer: A
Explanation:
Within Health Care Risk Management practice as outlined by ASHRM and the American Hospital Association Certification Center, establishing an accurate loss reserve requires an estimation of the probable financial exposure associated with a claim. A loss reserve represents the anticipated cost to resolve a claim, including indemnity payments and defense expenses.
Comparable verdicts in the county are particularly useful because they reflect jurisdiction-specific jury tendencies, local legal climate, and historical award patterns. Venue significantly influences claim valuation, as jury awards can vary substantially between counties and states. Reviewing similar case outcomes allows the claims manager to benchmark potential settlement or verdict ranges based on injury severity and liability factors.
The surgery center's claims history may inform overall risk trends but does not directly determine the value of a specific claim. The patient's total medical bills are relevant but represent only one component of damages and do not account for non-economic damages such as pain and suffering. The insurance limit per occurrence defines maximum exposure but does not guide the realistic reserve estimate unless damages approach policy limits.
Therefore, analysis of comparable local verdicts is most helpful in establishing an appropriate and defensible loss reserve.
NEW QUESTION # 48
The risk manager is called by an administrator and told that a member of the pharmacy staff was arrested last night for illegal distribution of controlled substances. Which of the following recommendations should the risk manager make to administration?
* Verify the pre-employment background check.
* Inventory controlled drug stock.
* Interview other pharmacy staff.
* Notify the National Practitioner Data Bank.
Answer: A
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, when a pharmacy staff member is arrested for illegal distribution of controlled substances, the organization must focus on immediate operational and patient safety concerns.
Verifying the pre-employment background check ensures compliance with hiring policies and identifies whether due diligence was properly conducted.
An immediate inventory of controlled drug stock is essential to detect diversion, identify discrepancies, and comply with DEA requirements for controlled substance accountability. Prompt reconciliation of medication records protects patient safety and mitigates regulatory exposure.
Interviewing other pharmacy staff supports investigation of potential diversion patterns, internal control weaknesses, and workflow vulnerabilities. This step aligns with system-based risk management and prevention of further loss.
Notification to the National Practitioner Data Bank is not automatically required based solely on an arrest.
NPDB reporting typically involves certain professional review actions, licensure restrictions, or clinical privilege actions, not merely criminal charges unless formal disciplinary action occurs.
Health Care Operations objectives emphasize safeguarding controlled substances, regulatory compliance, and internal investigation. Therefore, verifying background checks, inventorying stock, and interviewing staff are appropriate recommendations.
NEW QUESTION # 49
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