CMD Communication & Client Relations 3 — Questions and Answers
Question 1: A physician on staff consistently uses dismissive language when speaking to residents about treatment options. As Medical Director, what is the most appropriate intervention?
- Wait until the annual performance review to address the behavior
- Privately counsel the physician, provide specific feedback, and set clear expectations (Correct answer)
- Immediately suspend the physician's privileges pending investigation
- Ask nursing staff to mediate the communication issues directly
Correct answer: Privately counsel the physician, provide specific feedback, and set clear expectations
Private, specific counseling with clear expectations is the appropriate first intervention that preserves dignity while addressing the behavior directly.
Question 2: When communicating with a resident who has hearing loss, which accommodation is MOST important to implement first?
- Speak louder and more slowly without other modifications
- Write all communications exclusively and avoid verbal interaction
- Confirm the resident's preferred communication method and use assistive devices as needed (Correct answer)
- Schedule a speech-language pathology consult before any discussion occurs
Correct answer: Confirm the resident's preferred communication method and use assistive devices as needed
Confirming the resident's preferred method respects individual needs; some residents prefer lip reading, hearing aids, or written communication.
Question 3: A surrogate decision-maker is requesting aggressive interventions that appear inconsistent with a resident's previously expressed wishes. What is the Medical Director's role?
- Comply with the surrogate's requests since they have legal authority
- Refuse treatment and document the surrogate as non-compliant
- Facilitate a meeting to clarify the resident's prior wishes and apply the substituted judgment standard (Correct answer)
- Transfer care to another physician to avoid conflict
Correct answer: Facilitate a meeting to clarify the resident's prior wishes and apply the substituted judgment standard
The substituted judgment standard requires surrogates to decide as the resident would have decided; the Medical Director's role is to guide that process.
Question 4: Effective interdisciplinary team communication in long-term care MOST directly contributes to which outcome?
- Reduced staff overtime costs
- Improved care coordination and reduced adverse events (Correct answer)
- Decreased family involvement in care planning
- Faster physician documentation turnaround
Correct answer: Improved care coordination and reduced adverse events
Structured interdisciplinary communication reduces handoff errors and care gaps, directly improving safety and care quality outcomes.
Question 5: A resident's adult child who does not have healthcare proxy authority is insisting on reviewing the resident's medical records. How should the Medical Director advise staff?
- Provide the records immediately to avoid conflict
- Deny access and refer to HIPAA regulations and facility privacy policy (Correct answer)
- Allow limited verbal summaries but withhold written records
- Grant access only if the resident is not present to object
Correct answer: Deny access and refer to HIPAA regulations and facility privacy policy
Under HIPAA, medical records can only be released to authorized individuals; the Medical Director should ensure staff understand and follow privacy regulations.
Question 6: Which strategy BEST promotes psychological safety when a nursing staff member reports a near-miss event to the Medical Director?
- Focus the conversation immediately on identifying who made the error
- Thank them for reporting, focus on systems analysis, and avoid punitive language (Correct answer)
- Document the event as a performance issue in their personnel file
- Minimize the event verbally to prevent staff from becoming overly cautious
Correct answer: Thank them for reporting, focus on systems analysis, and avoid punitive language
Thanking reporters and focusing on systems rather than blame encourages a safety culture where staff feel safe disclosing errors and near-misses.
Question 7: A resident requests that their diagnosis not be shared with their adult children. Which principle guides the Medical Director's response?
- Family must always be informed to ensure care continuity
- Resident autonomy and confidentiality must be respected unless the resident lacks capacity (Correct answer)
- Disclosure to family is required when the condition is serious
- The Medical Director should consult with the ethics committee before responding
Correct answer: Resident autonomy and confidentiality must be respected unless the resident lacks capacity
Competent residents have the right to control their health information; confidentiality must be maintained unless the resident consents to disclosure.
CMD Communication & Client Relations 3
A physician on staff consistently uses dismissive language when speaking to residents about treatment options.
As Medical Director, what is the most appropriate intervention?