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ASHRM CPHRM Prüfungsplan:

Thema	Einzelheiten
Thema 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.
Thema 2	Risk Financing: This domain covers managing financial risks through insurance programs, claims coordination, loss analysis, and developing strategies to reduce financial exposure.
Thema 3	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.
Thema 4	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.
Thema 5	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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ASHRM Certified Professional in Health Care Risk Management (CPHRM) CPHRM Prüfungsfragen mit Lösungen (Q95-Q100):

95. Frage
Which of the following is an essential component of a risk management policy and procedure manual?

A. medical staff bylaws
B. department organizational chart
C. actuarial report
D. loss run report

Antwort: B

Begründung:
According to Health Care Risk Management standards outlined by ASHRM and the American Hospital Association Certification Center, a risk management policy and procedure manual should clearly define the structure, authority, and operational framework of the risk management program. An organizational chart is an essential component because it identifies reporting relationships, lines of authority, and accountability within the department and in relation to executive leadership and governing bodies.
A clearly documented organizational structure supports regulatory compliance, facilitates communication, and ensures that responsibilities for event reporting, claims management, patient safety initiatives, and regulatory oversight are properly assigned. It also demonstrates governance alignment and helps accrediting bodies evaluate program effectiveness.
Medical staff bylaws are separate governance documents that outline credentialing, peer review, and clinical governance standards. Actuarial reports are financial analyses used in risk financing decisions but are not part of a policy and procedure manual. Loss run reports summarize historical claims activity and support financial review but do not define program structure.
Health Care Operations objectives emphasize formal documentation of authority, processes, and accountability within the risk management framework. Therefore, inclusion of the department organizational chart is an essential element of a comprehensive risk management policy and procedure manual.

96. Frage
An unstable patient in the emergency department needs transfer to another hospital. Which of the following statements is true regarding the refusal of an on-call physician to treat this patient?

A. The on-call physician may refuse to participate in the care of any patient, for any reason.
B. The on-call physician is relieved of duty only if unavailable because of caring for another patient, or because of other circumstances outside the physician's control.
C. The on-call physician may refuse to participate in the care of a patient, as long as that refusal is not based on insurance status or other financial concerns.
D. The on-call physician is never relieved of duty to accept a patient needing specialized services.

Antwort: B

Begründung:
Under Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, obligations under the Emergency Medical Treatment and Labor Act EMTALA govern on-call physician responsibilities. When a hospital maintains an on-call roster to provide specialty services for emergency department patients, physicians listed on call are required to respond and participate in the evaluation and stabilization of patients with emergency medical conditions.
An on-call physician may only be relieved of duty if legitimately unavailable due to circumstances beyond their control, such as actively caring for another patient or being otherwise unable to respond in accordance with hospital policy. Refusal to treat for convenience or non-clinical reasons may constitute an EMTALA violation and expose both the hospital and physician to regulatory penalties.
A blanket right to refuse care is inconsistent with EMTALA requirements. While financial discrimination is prohibited, refusal for other non-justifiable reasons may still violate federal law. Conversely, stating that a physician is never relieved of duty is inaccurate, as legitimate unavailability may excuse performance under specific circumstances.
Legal and regulatory objectives emphasize compliance with EMTALA, proper on-call coverage policies, and documentation of availability. Therefore, the correct statement is that relief occurs only when the physician is unavailable due to circumstances outside their control.

97. Frage
A hospital's blood transfusions are99.7% error-free. Which function best estimates how many transfusions are likely before an error occurs?

A. Linear regression
B. Geometric distribution (time until first failure)
C. Multinomial distribution
D. Chi-square test

Antwort: B

Begründung:
If each transfusion has an independent probability of error, the number of transfusions until thefirsterror is modeled by thegeometric distribution, which describes "trials until first failure." The expected number of transfusions before an error is approximately, so. Risk management objectives use this type of reliability thinking to convert percentages into operational intuition: "Even a 0.3% error rate becomes a predictable event in high-volume processes." That insight supports prioritizing controls (barcoding, two-person verification, bedside ID checks, standardized labeling, transfusion time-outs) because rare-event rates still produce real harm over time. Interpreting reliability this way also helps boards and leaders understand that
"99.x%" can be unsafe in critical processes and that system redesign is often necessary to reach high reliability.

98. Frage
The source of many medication errors is:

A. Patient wristbands
B. Elevator delays
C. Radiology scheduling
D. Verbal/telephone orders (when avoidable and not properly verified)

Antwort: D

Begründung:
Verbal/telephone orders are widely recognized aserror-pronebecause they can be misheard, misunderstood, or transcribed incorrectly-especially with sound-alike drug names, confusing numerals (15 vs 50), background noise, accents, and interruptions. ISMP and patient safety advisories recommend minimizing verbal orders whenever possible and using safeguards such as read-back/confirm-back, spelling drug names, stating digits individually, and documenting promptly. Risk management objectives include reducing reliance on memory and imperfect communication by prioritizing written or electronic orders (CPOE), standardizing when verbal orders are permitted (true emergencies), and auditing compliance to prevent unsafe normalization. Because medication errors can cause severe harm, controlling verbal order risk is a high-yield safety intervention and improves legal defensibility by aligning practice with recognized safety recommendations.

99. Frage
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. Check the dates on the documents; the one with the more recent date is the valid power of attorney.
B. Tell the family to contact their respective counsel and return when they have worked this issue out.
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.

Antwort: A

Begründung:
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.

100. Frage
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