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| Topic | Details |
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| Topic 1 | - 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.
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| Topic 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.
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| Topic 3 | - 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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| Topic 4 | - 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.
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| Topic 5 | - 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.
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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q90-Q95):
NEW QUESTION # 90
A sentinel event is a patient safety event that reaches the patient and results in which of the following?
- A. death, permanent harm, or severe temporary harm
- B. death, temporary harm, or moderate harm
- C. permanent harm, severe temporary harm, or temporary harm
- D. severe temporary harm, moderate harm, or increased length of stay
Answer: A
Explanation:
According to Health Care Risk Management standards supported by ASHRM and The Joint Commission's sentinel event policy, a sentinel event is defined as a patient safety event that results in death, permanent harm, or severe temporary harm. Severe temporary harm is harm that is critical, life-threatening, or requires major intervention to sustain life, even if the patient ultimately recovers.
Sentinel events signal the need for immediate investigation and response because of the seriousness of the outcome. The Joint Commission requires completion of a root cause analysis and development of an action plan within specified timeframes following awareness of such an event. The focus is on identifying system vulnerabilities and preventing recurrence.
Temporary or moderate harm alone does not meet the sentinel event threshold unless it rises to the level of severe temporary harm. Increased length of stay, without death or significant harm, does not qualify as a sentinel event under the formal definition.
Clinical and patient safety objectives emphasize accurate event classification, structured investigation, and corrective action. Therefore, a sentinel event is one that results in death, permanent harm, or severe temporary harm.
NEW QUESTION # 91
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?
- A. Tell the family to contact their respective counsel and return when they have worked this issue out.
- B. Check the dates on the documents; the one with the more recent date is the valid power of attorney.
- C. Refer the matter to the Ethics Committee for resolution.
- D. Check the dates on the documents; the one with the older date is the valid power of attorney.
Answer: B
Explanation:
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.
NEW QUESTION # 92
The first layer of insurance that will respond to a specific type of loss or exposure is called
- A. baseline.
- B. primary.
- C. frontline.
- D. foundation.
Answer: B
Explanation:
According to Health Care Risk Management principles supported by ASHRM and the American Hospital Association Certification Center, insurance coverage for liability exposures is often structured in layers. The first layer of insurance that responds to a covered loss is known as the primary policy.
Primary insurance provides initial coverage once any applicable deductible or self-insured retention has been satisfied. It is responsible for defense and indemnity payments up to the policy's stated per-occurrence and aggregate limits. Only after the primary policy limits are exhausted do excess or umbrella policies respond.
Terms such as baseline, foundation, and frontline are not recognized technical classifications in layered insurance structures. In professional and general liability programs, organizations commonly maintain a primary layer followed by one or more excess layers to protect against catastrophic losses.
Risk financing objectives emphasize understanding policy structure, limits, attachment points, and coordination between layers to ensure adequate protection of organizational assets. Therefore, the correct term for the first layer of insurance that responds to a loss is the primary policy.
NEW QUESTION # 93
In general, how many steps should an FMEA proceed in each direction (upstream/downstream) when mapping a process for failure analysis?
- A. Steps are not mapped in FMEA
- B. Ten steps minimum regardless of complexity
- C. Two steps in each direction (a common practical rule-of-thumb)
- D. Only the current step; context is irrelevant
Answer: C
Explanation:
A practical FMEA requires enough process context to capture upstream causes and downstream consequences without becoming unmanageably large. A common operational rule-of-thumb is to examine roughlytwo steps upstream and two steps downstreamfrom a target step to uncover handoffs, dependencies, and failure propagation. Risk management objectives focus on identifying failure modes that originate earlier (e.g., incorrect patient ID at registration leading to lab/specimen mismatch) and harms that emerge later (e.g., delayed result communication causing deterioration). The exact boundary depends on complexity and risk; high-hazard workflows (blood products, surgery, chemo) may require deeper mapping. The goal is usable granularity: map, identify failure modes, score (S-O-D), prioritize, implement controls, and reassess residual risk.
NEW QUESTION # 94
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
- A. request evidence that the mother is the guardian of the patient and then release the medical record.
- B. verify that a specific release of information form has been signed by the patient and then release the medical record.
- C. check with the psychiatrist for a recommendation to release the medical record.
- D. contact the hospital's legal counsel to authorize the release of the medical record.
Answer: B
NEW QUESTION # 95
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