CPHRM CPHRM 3 — Questions and Answers
Question 1: Which element is MOST critical for an informed consent document to be legally valid?
- Patient's voluntary agreement with decision-making capacity (Correct answer)
- Physician's signature witnessed by two staff members
- Insurance pre-authorization for the procedure
- Hospital administrator approval of the consent form
Correct answer: Patient's voluntary agreement with decision-making capacity
Valid informed consent requires that the patient have decision-making capacity and voluntarily agree without coercion after receiving adequate information.
Question 2: The COSO Enterprise Risk Management framework emphasizes that risk appetite should be set by:
- The board of directors and senior management (Correct answer)
- The risk management department alone
- External auditors during annual review
- Front-line clinical staff
Correct answer: The board of directors and senior management
COSO ERM specifies that risk appetite is established by the board and senior management as part of strategy setting.
Question 3: A hospital's peer review records are generally protected from discovery in malpractice litigation primarily because of:
- State peer review protection statutes (Correct answer)
- HIPAA Privacy Rule provisions
- Federal anti-kickback statute
- Joint Commission confidentiality standards
Correct answer: State peer review protection statutes
Most states have enacted peer review protection statutes that shield peer review proceedings and records from discovery in civil litigation.
Question 4: Which metric measures the average cost of claims closed within a specified period, used to evaluate claims management effectiveness?
- Average paid loss per closed claim (Correct answer)
- Loss development factor
- Incurred but not reported (IBNR) reserve
- Occurrence rate per 1,000 patient days
Correct answer: Average paid loss per closed claim
Average paid loss per closed claim benchmarks how much money the organization is paying per resolved claim, indicating claims management efficiency.
Question 5: A 'tail' policy in professional liability insurance protects against:
- Claims reported after a claims-made policy has been cancelled or expired (Correct answer)
- Losses exceeding the primary policy limit
- Claims arising from excluded procedures
- Incidents occurring before the policy inception date
Correct answer: Claims reported after a claims-made policy has been cancelled or expired
A tail (extended reporting endorsement) extends the reporting window after a claims-made policy ends, covering incidents that occurred during the policy period but are reported later.
Question 6: The Joint Commission defines a sentinel event as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. The phrase 'risk thereof' means:
- Significant chance the outcome could have resulted in death or serious injury (Correct answer)
- Any event that requires filing an incident report
- Outcomes requiring regulatory notification within 24 hours
- Events with financial impact exceeding $100,000
Correct answer: Significant chance the outcome could have resulted in death or serious injury
'Risk thereof' expands the sentinel event definition to include near-miss events with significant potential for death or serious harm, not just actual adverse outcomes.
Question 7: In healthcare risk management, 'occurrence screening' is best described as:
- A systematic review of medical records to identify potential adverse events using pre-defined criteria (Correct answer)
- Random unannounced surveys of clinical units by the risk department
- Mandatory reporting of all patient falls to state health departments
- Analysis of near-miss reports submitted voluntarily by staff
Correct answer: A systematic review of medical records to identify potential adverse events using pre-defined criteria
Occurrence screening uses established criteria to retrospectively review medical records and flag potential adverse events for further investigation.
CPHRM CPHRM 3
Which element is MOST critical for an informed consent document to be legally valid?