Question 1

An incident report may be paper-based or in electronic form, and it is filed _____

Accepted Answer

Incident reports are typically filed separately from the patient record to protect the confidentiality of the information contained in the report. This also allows for easier tracking and access to the report for quality improvement purposes.

Question 2

Which is an outcome-based management function that implements measures to prevent or lessen the effects of risks at the lowest cost?

Accepted Answer

Risk management involves identifying potential risks and implementing measures to prevent or mitigate their impact. It aims to minimize the impact of risks at the lowest cost possible by prioritizing and allocating resources effectively. Quality management, security management, and utilization management may be related to risk management, but they do not specifically focus on implementing measures to prevent or lessen the effects of risks at the lowest cost.

Question 3

Which is an important area of quality control that uses both patient records and non-patient records?

Accepted Answer

Utilization management is the process of reviewing patient records, as well as non-patient records such as financial data and staffing information, to ensure that resources are being used appropriately and efficiently. This process helps to improve quality control by identifying areas for improvement and implementing strategies to address them. Quality management, risk management, and security management focus on different aspects of quality control, but do not typically use both patient and non-patient records in the same way as utilization management.

Question 4

Which is an issue associated with HIPAA security?

Accepted Answer

HIPAA security rules require that the retention of records must comply with applicable federal or state statutes and regulations, ensuring that records are kept for the required period and are protected against unauthorized access.

Question 5

With regard to importance, an incident report is _____.

Accepted Answer

An incident report is equally significant for both the defendant's and plaintiff's attorneys as it provides crucial information about the incident, which can be used in legal proceedings by either party.

Question 6

Risk managers may report to various lines of authority, depending on the organizational structure of the health care facility, including the _____.

Accepted Answer

Risk management in healthcare organizations most commonly reports to the safety department, as they are concerned with preventing harm and protecting patients from potential risks. While HIM and IT security departments may also be involved in risk management, they typically do not hold overall responsibility for the function. Reporting to outside legal counsel is not a common practice in healthcare risk management.

Question 7

When patient entries are completed in a timely and complete manner, authored and authenticated properly, they accurately reflect the _____.

Accepted Answer

Patient entries in medical records provide a comprehensive and accurate record of care provided to the patient, including diagnoses, treatments, and outcomes. Complete and timely documentation helps ensure that patients receive appropriate and high-quality care, and it also helps providers justify charges and demonstrate compliance with regulatory requirements. Failure to document care properly may increase the risk of liability for providers and compromise patient safety.

Question 8

Information about disciplinary actions is reported to the _____ by hospitals, medical societies, licensing boards, prepaid medical practices, and other health care entities.

Accepted Answer

Disciplinary actions are reported to the National Practitioner Data Bank, which collects and shares information about the professional conduct of healthcare practitioners. The Healthcare Integrity and Protection Data Bank and Medical Information Bureau also collect healthcare-related data, but they are not specifically focused on disciplinary actions. Quality Improvement Organizations are responsible for monitoring and improving the quality of healthcare services, but they do not collect information about disciplinary actions.

Question 9

Which is the term for an unexpected occurrence involving death or serious physical or psychological injury?

Accepted Answer

A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. This term is commonly used in healthcare organizations to refer to adverse events that require immediate investigation and response to prevent recurrence. Option A refers to the process of extracting useful information from large datasets, option B refers to the results of medical treatment or interventions, and option C refers to a method of identifying the root causes of problems or errors.

Question 10

Incident reports are covered by the _____ rule of evidence and business record exception, and they may or may not be admitted as evidence.

Accepted Answer

Incident reports typically contain out-of-court statements made by individuals who witnessed or were involved in the incident, making them hearsay. They may be admissible as evidence if they fall under an exception to the hearsay rule, such as the business record exception, but this is not guaranteed.

Question 11

Patient record documentation proves what did or didn't happen regarding patient care, and it establishes whether the _____ of care was met.

Accepted Answer

Patient record documentation establishes whether the standard of care was met.

Question 12

Which is the general term for any event or circumstance not consistent with the normal routine operations of the hospital, its staff, or the routine care of a patient?

Accepted Answer

Incident is the general term for any event or circumstance not consistent with the normal routine operations of the hospital, its staff, or the routine care of a patient. Accidents and errors are specific types of incidents, while situation is a vague term that does not necessarily involve unexpected or abnormal circumstances.

Question 13

A properly documented patient record will _____ the health care facility's risks.

Accepted Answer

A properly documented patient record will reduce the health care facility's risks. This is because accurate and complete documentation provides evidence of the patient's care, which can be used for legal, financial, and regulatory purposes. It also assists in communication among healthcare providers and ensures continuity of care.

Question 14

The development, implementation, and enforcement of facility-wide patient confidentiality policies are significant in _____.

Accepted Answer

Development, implementation, and enforcement of facility-wide patient confidentiality policies are significant in decreasing the risk of breach of confidentiality. These policies outline the procedures and responsibilities of healthcare providers when handling patient information, ensuring that sensitive information is kept secure and not disclosed to unauthorized parties. By having strict policies in place, healthcare facilities can minimize the risk of breaches and protect patient privacy.

Question 15

The clinical review of the appropriateness of admission and planned use of resources that can be and often is initiated prior to admission and conducted at specific time frames is called _____.

Accepted Answer

Utilization management involves reviewing the appropriateness and necessity of healthcare services, including the planned use of resources such as hospital admissions. This process is often initiated prior to admission and conducted at specific time frames to ensure that resources are being used efficiently and effectively. Case management involves coordinating and managing the care of individual patients, while quality management focuses on evaluating and improving the quality of healthcare services. Risk management involves identifying and mitigating risks to patients and healthcare organizations.

Question 16

The analysis and evaluation of all sentinel events that might be encountered by a health care organization is called _____.

Accepted Answer

Enterprise risk management involves the identification, analysis, and evaluation of all potential risks that an organization may face, including sentinel events. This process allows for proactive measures to prevent or mitigate potential harm to patients and ensures a comprehensive approach to risk management. Medical staff disciplinary process only deals with disciplinary actions against medical staff members, peer review analysis involves the evaluation of clinical practice among healthcare professionals, and traditional trending refers to the tracking of data over time to identify patterns or trends.

Question 17

Which legislation is designed to improve the exchange of information about decisions relating to the professional competence and conduct of physicians, dentists, and other heath care practitioners?

Accepted Answer

The Health Care Quality Improvement Act (HCQIA) is designed to improve the exchange of information about decisions relating to the professional competence and conduct of physicians, dentists, and other heath care practitioners. It established the National Practitioner Data Bank (NPDB), a central repository of information on healthcare practitioners, as well as reporting and immunity provisions for those who report to the NPDB. The other options listed are not specifically related to the exchange of information about healthcare practitioners.

Question 18

Which force influences the growth of risk management?

Accepted Answer

The Joint Commission, an accrediting organization for healthcare facilities, requires hospitals to implement risk management programs as a part of their accreditation process. This has influenced the growth and importance of risk management in healthcare organizations. The other options either do not relate to the growth of risk management or actually hinder it (such as the lack of state requirements for risk management programs).

Question 19

A risk manager would typically have a _____ background.

Accepted Answer

A risk manager deals with identifying, evaluating, and mitigating risks and potential threats to a business or organization. Therefore, a legal background would provide them with the knowledge and skills necessary to understand complex legal contracts, manage insurance policies, and navigate regulatory compliance issues. Although administrative, billing, and monetary backgrounds may provide some useful skills, they do not directly relate to risk management.

Question 20

The health information manager's role in risk management is to _____.

Accepted Answer

The answer of The health information manager's role in risk...

Quiz 12: Risk Management, Quality Management, and Utilization Management: Part A