ASHA Risk Management & Mitigation 3 — Questions and Answers
Question 1: In risk management terminology, what does 'likelihood' refer to when conducting a clinical risk assessment?
- The severity of harm if an adverse event occurs
- The probability that a specific hazardous event will occur (Correct answer)
- The number of clients affected by a given risk
- The cost of mitigating a potential adverse event
Correct answer: The probability that a specific hazardous event will occur
In risk assessment, likelihood (or probability) refers to how probable it is that a given hazard will lead to an adverse event.
Question 2: Which documentation practice best supports risk management in speech-language pathology?
- Recording only positive treatment outcomes to demonstrate efficacy
- Accurately documenting client status, clinical reasoning, interventions, and responses in real time (Correct answer)
- Summarizing sessions weekly to reduce administrative burden
- Omitting client refusals to protect the therapeutic relationship
Correct answer: Accurately documenting client status, clinical reasoning, interventions, and responses in real time
Accurate, timely documentation creates a legal record of clinical decisions and protects both the client and clinician in the event of adverse outcomes.
Question 3: A client who is status post-stroke presents with severe dysphagia and consistently refuses the recommended modified diet. After thorough counseling, they persist in their choice. What should the SLP do?
- Override the client's wishes and implement diet modifications without consent
- Respect autonomy, document thoroughly, ensure informed refusal is documented, and continue risk counseling (Correct answer)
- Discharge the client for non-compliance immediately
- Notify law enforcement of the client's unsafe decision
Correct answer: Respect autonomy, document thoroughly, ensure informed refusal is documented, and continue risk counseling
Competent adults have the right to refuse treatment; the SLP must document the informed refusal, educate about risks, and continue offering support.
Question 4: Which of the following represents the highest priority in Maslow's hierarchy as it applies to risk management during SLP clinical sessions?
- Achievement of long-term communication goals
- Physiological safety and freedom from physical harm (Correct answer)
- Psychosocial well-being and therapeutic rapport
- Advocacy for reimbursement and service access
Correct answer: Physiological safety and freedom from physical harm
Basic physiological safety must always be addressed before higher-order goals such as communication or psychosocial well-being.
Question 5: An SLP is asked by a physician to perform a bedside swallow evaluation on a patient who is heavily sedated and unresponsive. What is the appropriate risk management response?
- Perform the evaluation as requested to fulfill the consult
- Defer the evaluation until the patient is alert enough to participate safely and document the rationale (Correct answer)
- Perform a modified evaluation using only water trials
- Decline the consult and provide no further guidance
Correct answer: Defer the evaluation until the patient is alert enough to participate safely and document the rationale
Performing a swallow evaluation on an unresponsive patient poses significant aspiration risk and yields unreliable results; deferring and documenting is the safe clinical choice.
Question 6: Which of the following is an example of a systemic (organizational) risk factor in an SLP's clinical environment?
- A client's personal history of aspiration pneumonia
- High caseload size that limits available time for thorough clinical documentation (Correct answer)
- A client's severe cognitive impairment
- A client's refusal to wear hearing aids
Correct answer: High caseload size that limits available time for thorough clinical documentation
High caseload is an organizational/systemic risk factor because it is created by workplace structure rather than individual client characteristics.
Question 7: When an SLP identifies an unsafe condition in a healthcare facility (e.g., broken equipment), what is the most appropriate risk mitigation step?
- Continue using the equipment while monitoring for complications
- Remove the equipment from use, report the hazard to facilities management, and document the action (Correct answer)
- Ask a colleague to assess the equipment before making a decision
- Wait until the next safety committee meeting to report the issue
Correct answer: Remove the equipment from use, report the hazard to facilities management, and document the action
Removing unsafe equipment and immediately reporting the hazard through proper channels prevents client harm and fulfills the clinician's duty of care.
ASHA Risk Management & Mitigation 3
In risk management terminology, what does 'likelihood' refer to when conducting a clinical risk assessment?