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質問 # 51
The set of values, norms, guiding beliefs, and understandings that is shared by members of a healthcare organization and is taught to new members is
正解：D
解説：
Within Health Care Risk Management frameworks identified by ASHRM and the American Hospital Association Certification Center, organizational culture refers to the collective values, shared norms, guiding beliefs, and behavioral expectations that shape how members of a healthcare organization function. It influences decision-making, communication patterns, leadership styles, and responses to risk and safety concerns. Culture is transmitted formally through policies and training, and informally through leadership behavior, peer interactions, and organizational traditions.
Organizational culture plays a critical role in patient safety, compliance, and ethical conduct. A strong culture of safety encourages reporting of adverse events, supports transparency, and promotes continuous improvement. Conversely, a punitive or hierarchical culture may suppress reporting and increase liability exposure.
Corporate vision describes the aspirational future state of the organization. A strategic mission outlines the organization's purpose and objectives. Managerial ethics refers to principles guiding leadership conduct.
While these elements contribute to the broader organizational framework, they do not encompass the shared and socially transmitted system of norms and beliefs that define culture.
Therefore, the correct term describing shared and taught values and norms within a healthcare organization is organizational culture.
質問 # 52
Aside from clinical risk exposures, which of the following should be evaluated as part of a risk assessment concerning telemedicine?
正解：B
解説：
According to Health Care Risk Management standards outlined by ASHRM and the American Hospital Association Certification Center, telemedicine risk assessment must extend beyond clinical quality of care to include operational risks. Operational considerations encompass technology infrastructure reliability, cybersecurity protections, credentialing and privileging of providers across state lines, licensing compliance, documentation workflows, data storage, and continuity planning for system outages.
Telemedicine platforms rely heavily on secure networks, interoperability with electronic health records, and protection of protected health information. Operational failures such as system downtime, inadequate bandwidth, or insufficient training can disrupt care delivery and increase liability exposure. Additionally, compliance with regulatory requirements regarding interstate practice and reimbursement policies falls within operational risk management.
Behavioral and public awareness considerations may influence patient engagement but are not primary risk assessment categories. Financial risks are relevant in enterprise risk management; however, the question specifically contrasts clinical risk exposures with other telemedicine-related risks, making operational risk the most directly applicable.
Health Care Operations objectives emphasize comprehensive evaluation of technological, regulatory, and workflow factors in emerging service models. Therefore, operational risks should be evaluated alongside clinical exposures when assessing telemedicine programs.
質問 # 53
An organization has recently changed insurance. The risk manager receives a claim from a former patient on July 3, 2004, claiming injury and alleging negligence by the surgery staff on September 5, 2003. Which of the following would apply to this claim?
* a claims-made policy for the period 1/1/03 to 1/1/04 with a retro date of 1/1/02
* an occurrence policy for the period 1/1/03 to 1/1/04
* a claims-made policy for the period 1/1/03 to 1/1/04 with a 1-year tail coverage
* an occurrence policy for the period 1/1/04 to 1/1/05
正解：C
解説：
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, coverage determination depends on both the policy trigger and relevant dates. The alleged negligence occurred on September 5, 2003. Under an occurrence policy in effect from 1/1
/03 to 1/1/04, coverage applies because the event occurred during that policy period, regardless of when the claim was filed. Therefore, option 2 applies.
For a claims-made policy covering 1/1/03 to 1/1/04, coverage would require that the claim be made and reported during the policy period unless tail coverage is in place. Because the claim was received on July 3,
2004, after expiration of the 1/1/03 to 1/1/04 claims-made policy, coverage would apply only if a 1-year tail was purchased. Thus, option 3 applies.
Option 1 would not apply because the claim was made after the claims-made policy period ended, and no tail is specified. Option 4 would not apply because occurrence coverage from 1/1/04 to 1/1/05 would not cover an event that occurred in 2003.
Risk financing objectives emphasize understanding policy triggers, reporting requirements, and tail coverage.
Therefore, the applicable coverage scenarios are the occurrence policy for 2003 and the claims-made policy with tail coverage.
質問 # 54
The source of many medication errors is:
正解：C
解説：
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.
質問 # 55
A risk manager is reviewing the hospital's incident reporting system and notices that very few medication errors are being reported despite known high volumes of medication administration. Which of the following is the MOST appropriate action?
正解：D
解説：
Within Health Care Risk Management frameworks supported by ASHRM and the American Hospital Association Certification Center, effective incident reporting systems depend heavily on organizational culture. When underreporting is identified, the most appropriate first step is to evaluate whether a just culture exists and whether staff perceive reporting as safe, nonpunitive, and constructive. Fear of retaliation, lack of feedback, time constraints, and unclear reporting procedures are common barriers that suppress reporting rates.
A punitive response such as disciplining staff may further discourage transparency and undermine patient safety initiatives. Conducting a root cause analysis may be appropriate if a specific adverse event occurred, but in this scenario the systemic issue is underreporting itself, which is primarily cultural and operational in nature. Immediate notification of the liability insurer would not address the underlying safety system weakness.
Health care operations objectives emphasize creating a culture of safety that encourages voluntary reporting, learning, and system improvement. By assessing and strengthening reporting culture, leadership can improve data accuracy, enhance early risk identification, and support proactive patient safety management.
質問 # 56
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