0 of 618 Questions completed
Questions:
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading…
You must sign in or sign up to start the quiz.
You must first complete the following:
0 of 618 Questions answered correctly
Your time:
Time has elapsed
You have reached 0 of 0 point(s), (0)
Earned Point(s): 0 of 0, (0)
0 Essay(s) Pending (Possible Point(s): 0)
The ultimate goal of enterprise risk management is to:
Which of the following should be FIRST in a series of presentations to the Board, medical staff, and employees regarding a risk management program?
Ultimately, the accountability for the risk management program belongs to the:
The best content and format for a risk manager’s report to the board is:
A growing healthcare organization has a risk manager who did not have any staff and reported to the director of nursing, who reported to the chief operation officer. The risk manager presented information to the employees, and the information was filtered upward through senior management. The risk manager knew changes needed to be made due to the growth of the organization. One additional staff member was added, and a personal computer was purchased for the department. Although this scenario represents some changes designed to address the issues related to growth, the major flaw in the organization was:
Which of the following represents operations consistent with a risk manager’s role?
Which of the following are most important for the risk manager to consider when establishing
annual goals for the risk management department?
When preparing the risk management department budget, which of the following costs are likely to be provided by the organization for inclusion without the risk manager’s ability to modify?
A federal law that serves to limit the liability of hospital trustees is the :
Which of the following are primary elements of a risk management program?
When evaluating the effectiveness of the risk management program, it is important to
1.Confirm data is normalized using commonly recognized benchmarks.
2.Mandate adverse events are reported within 30 days of the occurrence date.
3.Examine trends of reduction in claims volume and severity.
4.Evaluate success of measures implemented to address identified risk.
In building an effective risk management program, which of the following areas should be considered?
1.Preventing patient injury.
2.Minimizing financial losses.
3.The ratio of risk managers to occupied beds.
4.The scope and cost of insurance coverage.
For a risk management program to be Effective, it needs which of the following?
1. Organizational Commitment.
2. Visibility and access.
3. Physician acceptance or understanding.
4. Complete authority.
To have a successful quality improvement process, a risk management program must have which of the following?
1. An autocratic management style.
2. Interactive multidisciplinary teams.
3. A mindset that most problems are caused by processes.
4. Full support of senior management.
A strong healthcare risk management program should be:
Risk management policies should be
1. Routinely shared with other hospitals.
2. Reviewed by corporate counsel.
3. The basis for staff education.
4. Updated annually.
Which of the following is the best measure of risk management activity effectiveness?
In the risk management process, the fourth step is:
Which of the following is NOT part of risk identification and analysis?
Which of the following categories of events most qualifies as a proper subject for risk identification and risk assessment within an enterprise-wide risk management program?
A risk manager’s review of claims from the past five years is an example of risk :
Which of the following steps in the risk management process refers to all of the options available to a risk manager in handling a given risk?
Which of the following reasons for under-reporting of incidents should be of greatest concern to a risk manager?
In the Just Culture model, which of the following types of behavior should result in the coaching of an employee?
According to the Joint Commission, an environment that enhances patient safety encourages
1. Recognition and acknowledgement of risks to patient safety.
2. Initiation of actions to reduce risks to patient safety.
3. Involvement of legal counsel to promote individual accountability
4. Focus on processes and systems.
An organization’s development of a no punitive approach to reporting of adverse events may result in an increase in the
A patient dies as a result of a transfusion error. Investigation reveals nurses have developed a “workaround”that involves cutting off patients’ barcoded wristlets and carrying them to centrally located barcode scanners, rather than bringing the barcoder to the patient bedside for scanning. Which of the following action plans will be most successful?
A wrong-site surgery was discovered in the recovery room. The staff immediately reported the event and identified a deviation in not completing a “time out” prior to the surgery. In review of the event, the organization’s risk manager can confirm that Just Culture principles are being followed as evidenced by which of the following behaviors?
1. Acknowledging that even professionals will take short cuts
2. Supporting blameless reporting of events
3. Admitting that a mistake has been made
4. Protecting confidentiality of event details to reduce liability
An organization recently adopted Just Culture principles in their approach to handling employee errors. The organization’s risk manager is asked by a unit director how to handle an employee involved in an error where there was no harm to the patient, but a workaround was used which resulted in an error. Which of the following is the risk manager’s best response?
Nurse Johnson was administering medications to the two patients in room 236 using the
bar-coding system. According to the facility’s written procedure, the nurse was to administer each patient’s medication separately. She was to scan the medication, then scan the patient’s bar code, check for any error alerts, and then administer the medication if no alerts appeared. Ike nurses complained that going out to the medication cart between patients was time-consuming. To save time, Nurse Johnson habitually scanned the medication and the patient’s bar codes while the medication was being administered. On this day, after giving patient A his medication, he immediately became severely short of breath, signaling an allergic reaction, and respiratory support was required. Following an investigation it was determined that Nurse Johnson had given patient A the medication for patient B and an error alert would have activated in the
bar-coding system. Nurse Johnson’s behavior is an example of:
Safety culture surveys are intended to assess the organizational and unit-level attitudes regarding patient safety. Survey results can reveal differences in perception of safety between types of staff (such as MD and RN) and between departments or teams. They can be used to identify priorities for improvement and to help create a performance improvement action plan.
Which of the following is most likely to occur if a health system punishes an individual for an unintended error that was the result of a system design issue?
A specific, fair, non-arbitrary method for determining system versus individual accountability in cases of medical error is known as which of the following?
A nursing assistant finds a patient on the floor. The patient explains he was to go to the bathroom when he slipped and fell. The incident is reported to the patient’s physician and head nurse. Who is responsible for completing the incident report?
Education and training of staff members regarding incident reporting should include which of the following instructions?
1. Document relevant facts and circumstances (e.g., patient ID, time, locations, identity of witness) while memories a refresh.
2. Where an error did not reach the patient (i.e., a near miss) and no serious harm was apparent, reporting is optional.
3. Where a single individual committed an error, it is necessary to investigate all pertinent facts and circumstances.
4. Where an error causing patient harm was the result of clerical error, an incident report should be completed
Which of the following is an advantage of occurrence screening compared to incident reporting?
Generally, an “incident” is defend as:
It is important to protect the discoverability of incident reports. Which of the following have significant impact on whether the reports are discoverable?
1. Joint commission/TJC standards.
2. State statutes.
3. Federal statutes.
4. Case law.
To maintain confidentiality of an incident report:
1. Send the incident report directly to risk management.
2. Never make the incident report part of the medical record.
3. Never mention the facts of the incident in the medical record.
4. Maintain the original in the risk management office and a copy in the originating department.
An alarm activates as a nursing home resident wanders away from the nursing facility. A certified nursing assistant (CNA) care aide turns off the alarm and attempts to locate the resident. The resident is located and returned to the nursing facility. The CNA aide should
The medical record historically has been a tool of risk management. In the event of an untoward outcome or unusual incident, documentation in the medical record should include all of the following EXCEPT:
1. A description of the occurrence
2. Comments about the notification of and related care provided by the patient’s physician
3. The fact that an incident report was completed
4. The fact that the risk manager was notified
Mrs. Cobb was admitted for surgery on her right leg. At the conclusion of the surgery, she awoke to learn that the wrong leg had been operated upon. An investigation revealed that the
pre-operative nurse had performed the site marking incorrectly and had placed the X-rays in the OR suite facing backward. The root cause analysis team identified that failure to have surgeons routinely participate in the site-marking process, with confirmation by the patient, was a participatory cause of the incident. This failure identified by the root cause analysis team is an example of:
Taxonomy is a necessary and important aspect of patient safety because:
the most effective human factors design strategy to reduce risk is to
A risk manager is working with the performance improvement director to formulate a strategy for compliance with The Joint Commission’s National Patient Safety Goals requiring accredited organizations to implement measure to ensure clinical alarms are always enabled and audible . One of the proposed measures is to modify alarms on ventilators so that the volume control cannot be turned lower than a predetermined level. This measure is an example of which of the following human factors design principles?
High-reliability organizations:
A key characteristic of a high-reliability organization is a reluctance to simplify. This means that the organization utilizes detailed processes for each key function and strives to include as many steps as possible to decrease the possibility of errors.
High-reliability organizations share all of the following characteristics EXCEPT:
Many organizations are striving to become “highly reliable.” Which of the following characteristics is NOT considered indicative of a highly-reliable organization?
As part of an enterprise-wide evaluation of inpatient events, which of the following should be included as part of a comprehensive report?
A nursing home resident attempts to wander away from a facility and activates the alarm when he exits the building via the main entrance. A nurse, who is in her first week of training, turns off the alarm at the nurse’s station. She then goes outside to find the patient. The resident is found and is returned to the facility. The nurse in training then completes an incident report about the occurrence. She places a copy in the medical record and sends the original to the risk manager. She also makes an objective entry about the event in the nurses’ notes in the medical record.
With regard to the alarm, which of the following is the most accurate statement?
A nursing home resident attempts to wander away from a facility and activates the alarm when he exits the building via the main entrance. A nurse, who is in her first week of training, turns off the alarm at the nurse’s station. She then goes outside to find the patient. The resident is found and is returned to the facility. The nurse in training then completes an incident report about the occurrence. She places a copy in the medical record and sends the original to the risk manager. She also makes an objective entry about the event in the nurses’ notes in the medical record.
With regard to the incident report, which of the following is the most accurate statement?
Based on historical root cause analysis data compiled by The Joint Commission, most sentinel events could be prevented if
An organization has had a sentinel event in which a procedure intended for patient X was performed on patient Y. Which of the following is the most likely root cause of this event?
The following three events occurred in a hospital:
1. A patient received a unit of blood that was the incorrect ABO type, resulting in a hemolytic transfusion reaction
2. An infant was discharged to the incorrect family
3. An assault on an on-duty staff member led to permanent harm Based on The Joint Commission’s (TJC’s)sentinel event policy, the risk manager.
If The Joint Commission becomes aware of a sentinel event that meets the definition of a reviewable sentinelevent, the organization is required to submit to the Joint Commission its root cause analysis and action plan, or other wise provide for Joint Commission evaluation of its response to the sentinel event under an approved protocol, within calendar days of the known occurrence of the event.
Which of the following statement about reporting a sentinel event is FALSE?
Which of the following should prompt a root cause analysis according to Joint Commission standards?
1. Surgery performed on the wrong body part
2. Infant abduction
3. Non-hemolytic transfusion reaction
4. Death from a community-acquired infection
Which of the following requires a root cause analysis be conducted according to the Joint Commission’s Sentinel Event Policy?
Which of the following takes place FIRST in a root cause analysis (RCA)?
A root cause analysis (RCA) is a process to determine what happened
A risk manager is reviewing the results of a root cause analysis (RCA) performed following a heparin administration error on an adult inpatient unit. One of the contributing factors was staff confusion about which one of several heparin administration protocols was to be followed. In addition, “floating” nurses were providing patient care at the time of the error. Which of the following measures is most likely to prevent recurrence of this error?
A 60-year-old woman fell at home and fractured her hip. She was brought to the hospital by EMS and was alert and oriented on admission. Following surgery, the patient was drowsy, but responsive to stimulation. On the morning following surgery, she was found to be non responsive. Thirty-six hours later, she remains in a coma with a poor prognosis. At a minimum, who should be involved in a root cause analysis (RCA) of this event?
A risk manager should use a fishbone diagram to illustrate
When left alone in an emergency department (ED) treatment room, a patient attempts suicide by
using the instruments in a suture set to slash his wrist. The patient is immediately taken to surgery
to repair the damage.To identify appropriate process changes, the risk manager should conduct
A risk professional facilitating a root cause analysis following a medication error learns that the RN did not use the dosing calculator in the electronic health record. As a next step, it is important for the risk professional to
The root cause analysis process is complete when
The main goal of a root cause analysis is to investigate serious adverse events and
A risk professional conducted a root cause analysis on a medical error. The root cause analysis revealed that the nurse acted with reckless behavior. Using the just culture model, which of the following is the best way to manage the nurse’s behavior?
In a failure mode and effects analysis (FMEA), the severity score is an estimate of the severity of the
The purpose of conducting a failure mode and effect analysis (FMEA) is to
Which of the following is true about failure mode and effects analysis (FMEA)?
Through media coverage, a risk manager hears of a recent patient safety event at a neighboring hospital. A medication was administered to three infants on two occasions resulting in one infant death and two infants requiring additional healthcare services. This medication is widely used in the risk manager’s organization. Which of the following is the risk manager’s best course of action?
A Failure mode, effects and criticality analysis (FMECA)) is a process used to investigate serious adverse events in an effort to identify the active and latent causes of the event.
An organization is purchasing a new cardiac monitoring system. Which of the following is important toconduct prior to implementation of the new monitors?
Following a sentinel event, prevention action items are identified. Which of the following should be considered a strong action item in Action Hierarchy?
A risk professional decides not to undertake a particular activity because the risk associated with the activity is unacceptably high. Which of the following techniques did the risk professional use?
Which of the following is an example of risk avoidance?
Which of the following is the risk control technique that a risk professional uses to eliminate the possibility for a loss to occur?
Which of the following are examples of loss prevention techniques?
1. Incident investigation
2. New employee education
3. Policy and procedure review and revision
4. Relocation of a business to a safer area
Obtaining an insurance policy for coverage of medical malpractice claims is an example of risk
Which of the following are risk treatment strategies?
1.Risk anticipation.
2.Risk avoidance.
3.Risk retention.
4.Risk transfer.
A risk professional has identified a new enterprise-wide technological risk in the transition to a cloud application for internal team collaboration and data storage. On a monthly basis, the risk professional receives a report on login failures, changes to network administrative permissions, and unauthorized sharing of files. This is an example of risk
A hospital has contracted with a construction firm to build a new plant. The hospital risk professional specified in the contract that the construction firm is responsible for any damage to the plant while it is being
D.shared the risk.
built. By doing so, the risk professional
Proactive risk mitigation activities include which of the following?
All of the following are effective error prevention strategies EXCEPT:
In July 2001, the Joint Commission created additional Patient Safety Standards that speak to risk management as a resource for policy-making, not just a data source for monitoring improvement. These standards require organizations to develop policies and procedures for which of the following?
1.Proper response to an adverse event
2. Prevention of accidental harm
3. Disclosure of adverse events to patients and families
4. Fiscal accountability
When debriefing after an adverse event that caused harm to a patient, which of the following are critical elements?
1. Individual team members should not feel personally responsible for the adverse event.
2. The focus is on individual team members’ strengths and weaknesses.
3. Teams learn practical applications to assist in dealing with difficult situations in the future.
4. Teams can develop new communication methods to use during subsequent events.
A patient undergoes a laparotomy and does not do well postoperatively. The patient is taken back to surgery and a retained towel is extracted. The physician refuses to inform the patient and instructs staff to advise the patient a previously undiagnosed condition is the cause. The risk manager should FIRST
A premature neonate in the NICU is receiving intravenous vancomycin for a severe infection. During the routine blood test to monitor the amount of medication in the blood at peak potency, levels were determined to betoxic. Due to the risk of the baby developing hearing loss as a result of the toxicity, a disclosure to the family is warranted. The initial disclosure discussion should include which of the following statements?
Which of the following elements should be included in a policy on disclosure of unanticipated outcomes?
1.Who is responsible for the disclosure?
2. Documentation of the disclosure
3. How to disclose deliberations from the peer review process
4. Follow-up discussions with patient and family
A risk professional receives a call from a nurse manager seeking help with a patient’s family member. The nurse manager states she has tried everything to please this family. She indicated the family threatened a lawsuit.The nurses are now afraid to go in the room. Upon hearing this, the risk professional should
In disclosing a medical error to a patient, it is important the care provider
Which of the following is the most appropriate information to share with the family during an initial disclosure process?
A physician contacted the risk professional to report a wrong site surgery. The physician stated disclosure of the event to the patient has occurred. The risk professional should be aware that
Which of the following represents an appropriate disclosure of an adverse event?
Following an untoward event, the principal purpose of disclosure is to
A 12-year old female is administered an excessive amount of a drug and develops transient tachycardia that necessitate monitoring in the pediatric intensive care unit for eight hours. If the preliminary information indicates there is clear liability on the part of the organization, the most prudent course of action for the risk manager would be to
Upon removal, an epidural catheter is noted to be broken, with approximately 6 inches remaining in the patient. Risk management actions should include preserving the broken catheter and notifying the
1. Food and Drug Administration (FDA).
2. Manufacturer.
3. Occupational Safety and Health Administration (OSHA).
4. Professional liability insurer.
A defibrillator failed during resuscitation and a patient died. It is unclear what role, if any, the defibrillator failure played in the patient’s death. The risk manager sequesters the defibrillator. Which of the following should the risk manager do NEXT?
Medical devices may play an essential role in the management of a claim. If a medical device is involved,which of the following should not be done?
During an operation on an I8-year-old male in a Joint Commission accredited hospital, an electrocautery device ignites the surgical drapes. Operating room staff quickly extinguishes the fire. However, the patient suffers second-degree burns to his right thigh. Based on all applicable state and federal laws and regulations, what is the risk manager’s best course of action?
Within the Safe Medical Device Act, the Food and Drug Administration (FDA) defined a reportable event as”information [from any source) that reasonably suggests that a device has or may have caused or contributed to a death or serious injury.” Such events must be reported to the FDA alone whenever:
1. They involve a serious patient injury
2. They involve a patient death
3. The identity of the manufacturer of the device is unknown
4. The distributor of the device is unknown
A patient expires in the Operating Room due to a suspected anesthesia machine failure. The risk professional should first
The Safe Medical Devices Act of 1990 requires
The Safe Medical Devices Act (SMDA) applies to
During the contract review process, the risk manager is responsible for Mi
1. Evaluating insurance coverage.
2. Using a systematic approach to evaluate liability issues.
3. Recognizing and referring certain contractual issues to legal counsel.
4. Reviewing the cost of the contract to ensure the services purchased are within budget.
Which of the following is necessary for a contract to exist?
1. The contract represents a “meeting of the minds”
2. There is a consideration of “this for that”
3. The purpose of the contract is a legal one
4. The contract is documented in writing
If a Facility is accredited by the Joint Commission, which of the following are important risk management reasons to review contracts?
1. To assure the Joint Commission standards are met regarding contracted services
2. To evaluate indemnification/hold harmless provisions
3. To apply appropriate state law CO the COM= provisions
4. To monitor financial performance for the organization
Legal essentials for a valid contract include:
1. A bargained for exchange of legal value between die contracting parties
2. The purpose or object of the contract is legal
3. The contract must be in writing
4. The contract contains risk assumption provisions
A surgeon has asked the hospital to allow for use of a new electronic device that assists with closing incisions.When reviewing the vendor’s contract for use of the device, the healthcare risk professional should ensure which of the following is covered in the terms?
An organization has decided to complement its successful wound service line with the addition of two hyperbaric chambers. The decision was made to utilize these services through a well-known contracted service.The best way to assess the risk this new service may pose is to
For a contract to be legally valid, it must contain which of the following?
A 72-year-old male presents to an emergency department with a history of severe abdominal pain and deteriorating mental status. The consulting surgeon identifies that the patient needs surgery for a ruptured appendix and resulting sepsis. The patient has an advance directive and staff is unable to locate the patient’s only surviving son. Which of the following is the best principle to guide the surgeon’s decision regarding whether to proceed with surgery?
Which of the following are examples of advance medical directives?
In the process of determining whether a patient has adequate mental or cognitive capacity to make healthcare decisions, the physician must determine if the patient is:
Which of the following is NOT a type of consent?
Mature or emancipated minors generally can consent to treatment of which of the following?
Which of the following topics must be discussed during the informed consent process?
An unknown child is carried into a plastic surgeon’s office by a witness after a hit and run. The child has sustained notable trauma and is unconscious. The child has significant bleeding from a laceration, the office calls 911 and the risk professional because the surgeon wants to suture the wound. If the surgeon sutures the wound, is consent needed?
Under which of the following conditions can a relative consent to a minor’s health care treatment?
A power of attorney for healthcare comes into effect and is used when a patient
Which of the following describes written or verbal instructions when patients are unable to make decisions for themselves?
Which of the following is NOT a type of consent?
The emergency except on to the informed consent rule allows physicians to assume an unconscious patent, about whom there is no information, would have given his consent to a procedure in an emergency situation when
A patent’s right for advance directives is based on the ethical principle on
Important considerations in evaluating the legality of an informed consent include
A hospital-informed consent policy and procedure should provide clinical staff with which of the following?
Informed consent is based upon the principle of
Which of the following are four commonly accepted principles of biomedical ethics?
The Patient Self-Determination Act (PSDA) requires facilities to
The Patient Self-Determination Act (PSDA) obligates which of the following entities to provide their clients with information regarding advance directives?
The Patient Self-Determination Act obligates which of the following entities to provide their clients with information regarding advance directives?
Which of the following federal laws requires healthcare agencies to provide patients with information about advance directives?
The Patient Self-Determination Act (PSDA) requires facilities to do which of the following?
Which of the following statements is true about the staff member who refused to administer the transfusion?
When the above patient refuses the transfusion, which of the following actions should be taken?
Ethics consultations and decision-making done systematically will help to ensure that ethical principles are met. This approach would include all of the following except:
Which of the following obligations applies to an off-campus outpatient facility one mile away from a hospital?
A physician, concerned about the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, asks the risk manager whether she can talk to a patient about his condition in front of the patient’s friend. The risk manager should advise protected health information can only be disclosed if the
The Health Insurance Portability and Accountability Act (HIPAA):
According to HIPAA, which of the following disclosures are permitted without an individual’s authorization and without granting the individual an opportunity to agree or object to the disclosure?
HIPAA requires a written agreement for covered entities and business associates in which of the following situations?
For which of the following purposes can a healthcare facility use and disclose patient health information without the patient’s authorization based on the HIPAA Privacy Rule?
Which of the following documents explains a healthcare organization’s rules for releasing a patient’s medical information?
A member of the risk management team is married to a physician and is known to socialize with the nursing staff. As her supervisor, the risk manager is concerned about potential risk exposure. Which of the following is of greatest concern?
When evaluating IT systems for potential impact of a ransomware attack, which of the following findings should be the highest priority on an action plan?
Which’ of the following statements about peer review records is NOT correct?
To encourage the participation of physicians in the peer review process, federal law provides protection from civil liability for those who participate in good faith in this endeavor. The specific federal law that provides such protection is:
The Joint Commission standards require Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) processes include monitoring techniques that
A risk manager for a hospital with a self-insured/self-administered professional liability insurance program settles a litigated claim for $25,000 on behalf of the hospital and its employed physician. Under the Health Care Quality Improvement Act (HCQIA), the risk manager
Which of the following grants hospitals limited immunity for physician staff credentialing meetings if the hospital meets certain procedural standards?
Which of the following should be reported to the National Practitioner Data Bank (NPDB)?
A surgeon performs a hysterectomy on a 25-year-old female due to an abnormal Pap smear result obtained as an outpatient in the physician’s office. The final pathology report on the uterus states the uterus contains only benign inflammation with no cancerous cells present. The case is referred to the Obstetrics department, where the actions of the surgeon are discussed at length. It is concluded that the surgeon acted in good faith based on the incorrect Pap smear from an independent laboratory. The patient sues the obstetrician and the hospital, and seeks to obtain copies of the minutes and any other documents related to the Obstetrics department meeting. Which of the following is true?
Federal or state criminal convictions of healthcare practitioners related to the delivery of healthcare services must be reported to the:
Under the requirements of the Healthcare Quality Improvement Act, hospitals must query the national Practitioner Data Bank upon physician appointment and reappointment, but no less than:
The Healthcare Quality Improvement Act requires the reporting of medical professional liability payments made on behalf of certain healthcare practitioners to the National Practitioner Data Bank and the appropriate state licensing board within days.
According to the Healthcare Quality Improvement Act, which of the following require(s) reporting of the medical professional liability payments to the National Practitioner Data Banks
The National Practitioner Data Bank (NPDB) requires which of the following from medical malpractice payers?
Medical Staff Credentialing is mainly governed by which of the following?
Which of the following are the requirements for a hospital physician to perform robotic surgery?
Which of the following is an appropriate agency to utilize when credentialing a provider for privileges at a health care organization?
The due diligence process is a complicated, multi-faceted process undertaken when acquisitions are being considered. Which of the following are objectives of the due diligence process?
The exchange of financial information during a potential acquisition occurs during
Hiring an actuary to prepare a loss forecast is most appropriate for which of the following reasons?
The total incurred column in a loss run reflects the sum of
Data collection and analysis of potential compensatory events (PCEs), open and closed claims, and loss runs
A Health System Board wishes to compare the loss experience of each hospital in the system. Which of the following information displays would best inform them?
Total liabilities for losses during a given period are calculated by adding the incurred losses to the
Analyzing historical loss experience and addressing trends
In preparing an employee for deposition testimony, the employee should:
One of the risk manager’s responsibilities, in concert with the organization’s legal counsel, is to prepare a witness for trial. In that regard, which of the following statements is FALSE?
The enterprise risk professional can mitigate negative impact of litigation stress on health care professionals by
When supporting and preparing defendants through phases of litigation, risk managers should
When expecting legal action against the organization, a healthcare risk professional should
The hospital risk management department receives a letter from an attorney stating that she represents a former patient who allegedly suffered an injury from a fall. The patient’s attorney states that all records, evidence, communications, photos, and other information related to the fall must be maintained in anticipation of filing a lawsuit. Which of the following best describes the attorney’s communication?
A summons and complaint was received involving a patient who died as a result of an adverse patient event. The risk professional remembers the event and how upset the involved practitioner was when it happened. Which of the following would be the next best step for the risk professional?
The hospital risk professional can accept service of a summons on behalf of
How should a risk manager respond to a subpoena for medical records, properly served on the facility, which seeks a patient’s history of mental health and substance abuse diagnosis and treatment?
A medical records custodian receives a subpoena duces tecum to appear at a deposition with a medical record. Attached to the subpoena is a letter from the requesting plaintiff attorney advising that if a copy of the record is mailed, then appearance at the deposition is not required. A risk manager should advise the custodian to
The process of legal discovery includes which of the following?
The hospital receives a subpoena for a patient’s medical records. The risk professional should advise staff to do which of the following?
The standard of care in a medical malpractice trial is established by:
1.State licensing regulations
2.Standards published by medical professional associations
3.Expert opinion testimony.
4.Quality of care measures defined by voluntary accreditation organizations.
A 72-year-old Alzheimer’s patient develops acute congestive heart failure. Several invasive procedures are performed, but the patient dies within 12 hours of admission. His family files a wrongful death lawsuit naming all the physicians and the hospital as defendants. At trial, the standard of care in the above use must be determined by
The risk professional working with defense council on selecting an expert witness in an alleged medical negligence case involving failure to diagnosis breast cancer. Which of the following would be the best selection of potential experts?
Early identification of potential compensatory events can best be accomplished through reviewing which of the following?
A health maintenance organization (HMO) advertises itself as the best in the industry and that its physicians can manage any illness or injury. If a patient uses the HMO based on these claims and is subsequently injured, the patient might sue the HMO. Which of the following might be appropriate grounds for such a suit?
The legal theory res ipsa loquitur would most likely apply to which of the following scenarios?
Hospitals may be exposed to liability from all but which of the following:
A 50-year-old school teacher is brought to the hospital to rule out metastatic disease. She has a history of breast cancer, but chose not to undergo a round of chemotherapy at the time of her diagnosis four years prior to this admission. During this hospitalization she is given five doses of an anticoagulant in error. She begins to have seizures, and a CT scan reveals bleeding in her brain. The physicians, nurses and pharmacists do not discover the error until it is picked up on a routine pharmacy audit. The patient’s family is told of the error, and the patient dies in the ICU two weeks following the last dose of the anticoagulant. Autopsy reveals metastatic disease to her brain contributed to her bleeding.
In the above case, the most applicable legal term that the plaintiff might use to establish a claim against the nurses and pharmacists would be:
The legal theory res ipsa loquitur would most likely apply to which of the following scenarios?
A 44-year-old man develops severe chest pain while mowing his lawn. His family calls 911, and he is rushed via ambulance to one of the local hospitals. The emergency room physician performs a comprehensive workup and discharges the patient with a diagnosis of costochondritis. He dies that night while asleep in his own bed. The patient’s family files suit against the hospital and the emergency physician, a contracted provider for the hospital. The most likely legal theory that can be used against the hospital would be.
A doctor asks the clinic nurse to administer DPT first booster vaccine to an 18-month-old child. The nurse inadvertently administers MMR, which had been drawn up for another patient. The mother sues the clinic. Which of the following potential claims against the doctor is defensible?
A hospital is sued for the acts of one of the employees who failed to monitor a patient’s blood sugar. The patient ended up with permanent brain damage from hypoglycemia after their glucose level dropped. This is an example of
An organization receives notification of a medical malpractice lawsuit related to the unintended retention of a surgical sponge. Which of the following is the most relevant legal theory for this type of claim?
A pregnant diabetic patient presents to the hospital in labor. The obstetrician successfully delivers the baby by Cesarean section. Two days later, the patient complains of fever, abdominal distension, and pain. Diagnostic tests suggest a retained foreign body. The patient provides consent for surgery and a missed surgical sponge is removed via laparotomy. The patient recovers but files a complaint against the obstetrician. Which of the following is the most applicable legal term that the plaintiff might use to establish a claim against the obstetrician?
A healthcare facility with a claims-made policy has received a written demand for compensation. Which of the following should the risk professional do next?
The risk manager is usually expected to report which of the following to the insurer:
It is the risk manager’s responsibility to report actual or potential claims to the healthcare organization& insurance provider. Which of the following are generally considered reportable?
After notifying the insurer and internal litigation department of a potentially high exposure event, the risk professional should
The attorney for a patient presents a claim related to an injury received by the patient while in the facility. After investigation, the risk manager believes the claim has some merit and the plaintiff appears open to consideration of settlement. For a variety of reasons, the risk manager believes this claim should be settled prior to trial, if possible. Which of the following alternative dispute resolution methods is the best to bring this to closure?
An alternative dispute mechanism that results in a decision by a neutral third party is
For the facility’s risk management professional, an appropriate strategy for managing the claim would be which of the following:
There are several ways for the above claim to come to resolution. An optimal approach would be:
Which of the following are advantages of using an alternative dispute resolution mechanism as compared to going to trial?
An advantage of mediation over civil trial is
Which of the following is an alternative dispute mechanism where a neutral third party acts as a facilitator to see if the parties can come to a mutually acceptable agreement?
An insurance company may issue a reservation of rights letter after receiving a claim. The reservation of rights letter serves which of the following purposes?
Which of the following statements regarding monetary damages for a breach of contract is true?
Which of the following best describes the implications of a reservation of rights letter from an insurance carrier?
Which of the following clauses is “the voluntary relinquishment by the insurer or self-insurer of the right to recover from a third party”?
Punitive damages are designed to do which of the following?
Which of the following statements is TRUE?
A captive insurance company is:
Self-insurance works best when an organization has which of the following?
Which of the following are generally acceptable planned strategies of funding payments for medical professional liability claims?
When reserving for professional liability claims, the risk manager should set
The following policy information is available:
What is the total cost of closed claims for policy year 2012?
Once reported to the insurance carrier, reserving will take place. True statements concerning setting an indemnity reserve are:
Reserving a claim— that is, Identifying what amount of money will be paid out in indemnity and loss adjustment costs by the time the case is settled or resolved— is more an art than a science. Therefore
As a claim matures, new information from experts, defense counsel or adjusters may develop. In that case, which of the following is TRUE?
Which of the following describes the difference between a cross-claim and a counter-claim?
the most important aspect of claims handling is:
The investigative process is composed of which of the following steps?
When a potentially compensable event occurs and it is determined that the event might be a significant one, the original medical records should be:
The risk management professional will assist in the investigation of the lawsuit in conjunction with defense counsel. Some of the tasks include:
Interrogatories may include questions thought to be objectionable by the risk manager. Which of the following objections, while appropriate, must be accompanied by a detailed explanation?
A medical malpractice case has been filed in the above described situation. You are the risk management professional. The insurance company has assigned the case to a law firm and the initial discovery has commenced. Interrogatories have been requested of the defense. The best person to answer these would be:
Interrogatories are
Which is NOT a valid primary reason for selecting a particular defense attorney?
A 24-year-old patient presents to the emergency department following a MVA with a complaint of headache. The contracted ED physician orders a CT scan and requests consultation with Trauma Services. The patient is admitted for observation. Six hours after admission, the patient arrests, and it is determined she is brain dead from a brain hemorrhage. Review of the record determines that a bleed was evident on the CT scan and that there was a delay in evaluating and treating the patient.
In the above scenario, who are the potential defendants?
In the above case, are all four elements of negligence present?
A hospital has primary insurance of $5 million. The excess insurance arrangement is as follows:
Insurer A: $4 million Insurer B: $3 million excess of $9 million Insurer C: $7 million excess of $12 million Insurer D: $1 million excess of $19 million This insurance arrangement is referred to as
The insurance industry is cyclical. It is characterized by periods noted as “hard” and “soft” markets. Which of the following statements is TRUE?
The insurance industry is cyclical. It is characterized by periods of time noted as “hard” and “soft” markets. ‘Which of the following statements is TRUE?
Most healthcare risk managers gain access to the commercial insurance market by using an insurance broker or agent. Which of the following statements is FALSE?
Managing a request for insurance proposals is a complicated yet necessary task. With regard to market proposals and conceptual proposals, which of the following is FALSE?
Which of the following markets is best to retain less of a given loss exposure and increase the amount of insurance purchased?
An original contract should include which of the following elements?
An insurance policy contains what four standard elements:
Which of the following elements of a standard insurance policy identifies the named insured and describes the property or activity to be insured?
A hospital’s insurance policy provides for replacement cost of its building. Replacement cost is the
For most general business decisions, which of the following types of insurance affords hospital board members the best protection from liability claims?