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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q109-Q114):
NEW QUESTION # 109
When conducting a safety audit in an Emergency Department, what does an administrator need to obtain first?
- A. A written set of safety standards/criteria for the audit
- B. A marketing plan
- C. A patient satisfaction script
- D. A list of staff birthdays
Answer: A
Explanation:
A safety audit must be anchored to explicitstandards-policies, regulatory requirements, evidence-based guidelines, and internal procedures-so observations can be evaluated objectively. Without defined criteria, the audit becomes subjective and inconsistent, limiting its usefulness and defensibility. Risk management objectives for ED audits include verifying compliance with high-risk workflows (triage, medication storage, high-alert meds, behavioral health safety, EMTALA processes, handoff communication, alarm management), identifying hazards (environmental risks, crowding, staffing mismatch), and ensuring corrective actions are tracked to closure. A written standard also supports repeatability-audits can be compared over time, and improvements can be measured. This approach aligns with quality management principles: define the requirement, assess the gap, implement controls, and monitor effectiveness.
NEW QUESTION # 110
A risk manager is reviewing the professional liability insurance policy for the limits of liability. Which of the following should the risk manager review FIRST?
- A. exclusions
- B. declaration
- C. insuring agreement
- D. conditions
Answer: B
Explanation:
According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, the declarations page is the first section a risk manager should review when assessing limits of liability in a professional liability insurance policy. The declarations page summarizes key policy information, including named insureds, policy period, coverage types, limits of liability per occurrence and aggregate, deductibles or self-insured retentions, endorsements, and premium details.
Because the question focuses specifically on limits of liability, the declarations page provides the most direct and concise statement of coverage limits. It serves as the policy's summary and reference point for determining financial exposure and coverage structure.
The insuring agreement defines the scope of coverage and triggers for defense and indemnity obligations but does not list specific limit amounts. Exclusions outline what is not covered, and conditions specify policyholder responsibilities such as notice and cooperation requirements. While all sections are important for comprehensive review, the declarations page is the appropriate starting point when verifying coverage limits.
Risk financing objectives emphasize careful policy analysis to ensure alignment between coverage limits and organizational risk exposure. Therefore, the declarations page should be reviewed first when assessing limits of liability.
NEW QUESTION # 111
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?
- A. comparable verdicts in the county
- B. the patient's total medical bills
- C. amount of insurance allowed per occurrence
- D. the surgery center's claims history
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 # 112
What are the four elements of the SBAR situational briefing model?
- A. Scene, Background, Assessment, Response
- B. Situation, Background, Assessment, Recommendation
- C. Summary, Background, Action, Review
- D. Situation, Behavior, Action, Result
Answer: B
Explanation:
SBAR is a standardized communication framework used to reduce preventable harm caused by incomplete, unclear, or delayed clinical communication-especially during handoffs, escalations, and urgent updates. The four elements areSituation(what is happening now),Background(clinical context and relevant history), Assessment(what you think the problem is based on data), andRecommendation(what you need/request as the next step). By forcing concise structure, SBAR improves shared situational awareness, supports early recognition of deterioration, and reduces ambiguity ("hinting and hoping"). From a risk management standpoint, SBAR strengthens frontline reliability, decreases communication-related sentinel events, and supports defensible care by demonstrating a consistent escalation process. It also aligns with patient safety objectives: clearer teamwork, faster response to clinical changes, and fewer omissions during transitions of care.
NEW QUESTION # 113
For a risk management program to be effective, it needs:
- A. Only a policy manual
- B. Only incident reporting software
- C. Only insurance coverage
- D. Organizational commitment, visibility/access, and physician engagement
Answer: D
Explanation:
Effective risk management requires more than tools-it needs organizational commitment (tone at the top), operational visibility (access to events, leaders, data), and physician engagement because many high-severity risks involve medical decision-making and clinical leadership. Risk management objectives include preventing harm (patient safety), reducing financial loss (claims and insurance costs), ensuring compliance, and building a learning culture. Without executive and board support, corrective actions stall; without visibility, emerging risks are missed; without physician buy-in, clinical process redesign fails. Successful programs integrate with quality, patient safety, compliance, legal, and operations, and they use structured methods (RCA/FMEA, audits, claims trend analysis) to drive measurable improvement. This also strengthens defensibility: it shows governance, action, and continuous improvement-key elements in regulatory review and litigation.
NEW QUESTION # 114
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