CPHRM Risk Identification 4 — Questions and Answers
Question 1: A risk manager reviewing the organization's claims history notices a cluster of retained surgical instrument cases. This is an example of risk identification through:
- Prospective analysis
- Retrospective claims analysis (Correct answer)
- Environmental scanning
- Clinical benchmarking
Correct answer: Retrospective claims analysis
Retrospective claims analysis reviews past malpractice claims to identify patterns that indicate systemic risk areas.
Question 2: Which committee is MOST likely to provide risk managers with information about clinical risks related to physician performance?
- Finance committee
- Medical executive committee (Correct answer)
- Compliance committee
- Facilities management committee
Correct answer: Medical executive committee
The medical executive committee oversees physician credentialing, peer review, and performance issues that directly relate to clinical risk.
Question 3: A patient safety officer notices that pressure ulcer rates are higher in the ICU than in other units. The NEXT step in risk identification is to:
- Immediately implement a new skin care protocol
- Conduct a detailed analysis of ICU processes related to skin care (Correct answer)
- Report the ICU charge nurse to administration
- Purchase new pressure-relieving mattresses
Correct answer: Conduct a detailed analysis of ICU processes related to skin care
Before implementing solutions, a detailed process analysis is needed to identify the specific root causes contributing to the elevated rate.
Question 4: In the context of CPHRM, 'risk identification' in the emergency department most commonly involves which unique challenge?
- Managing elective procedure scheduling
- Identifying risks in a high-volume, high-acuity, time-pressured environment (Correct answer)
- Monitoring chronic disease management protocols
- Reviewing outpatient coding accuracy
Correct answer: Identifying risks in a high-volume, high-acuity, time-pressured environment
The ED's high volume, acuity, time pressure, and frequent handoffs create a uniquely complex risk environment requiring targeted identification strategies.
Question 5: Which of the following is an example of using 'passive surveillance' for risk identification?
- Conducting FMEA on a new clinical process
- Reviewing spontaneously submitted incident reports (Correct answer)
- Performing structured patient safety rounds
- Analyzing real-time EHR alerts
Correct answer: Reviewing spontaneously submitted incident reports
Passive surveillance relies on voluntary, spontaneous reporting by staff rather than active systematic data collection methods.
Question 6: A risk manager identifies that informed consent documentation is frequently incomplete for a specific surgical procedure. This risk was MOST likely identified through:
- Patient satisfaction scores
- Medical record audits (Correct answer)
- Malpractice reserve analysis
- Staff satisfaction surveys
Correct answer: Medical record audits
Medical record audits systematically review documentation to identify compliance gaps and process failures such as incomplete informed consent.
Question 7: The 'Swiss Cheese Model' of accident causation is used in risk identification to illustrate that:
- A single failure is always sufficient to cause harm
- Multiple system defenses must all fail simultaneously for harm to occur (Correct answer)
- Human error is the primary cause of all adverse events
- Risk identification should focus only on frontline workers
Correct answer: Multiple system defenses must all fail simultaneously for harm to occur
The Swiss Cheese Model shows that harm results when holes (failures) in multiple defensive layers align, enabling a hazard to reach the patient.
CPHRM Risk Identification 4
A risk manager reviewing the organization's claims history notices a cluster of retained surgical instrument cases.
This is an example of risk identification through: