Which of the followings is not a characteristic of board engagement in quality improvement and patient safety identified by the Executive Quality Improvement Survey?

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  1. Which of the following best define Risk analysis?A process used by the person or the person’s assigned risk management functions to determine the potential severity of the loss from an identified risk, the probability that the loss will happen, and alternatives for dealing with the risk.

    Working with business units to assist the leaders in understanding risk in business transactions

    Advising staff and leaders on the best approach to manage the new or emerging risk for the organization

    Providing leadership to maintain an understanding of the organization’s mission and goals, and defining who is able to provide direction

2 points

QUESTION 2

  1. The purpose of patient safety is to provide a safe environment, to explore the possibility of failure, and to create “defenses” that will change the current system of operation in order to reduce the potential for failure.True

    False

2 points

QUESTION 3

  1. Patient safety is about the organizational tactics to fix problems. Focus is on individual case, Post- event investigation, Implement tactics to address the event rather than the system failures, Relationship with legal standard of care, Unexpected outcomes drive the process.True

    False

2 points

QUESTION 4

  1. Which of the followings is not a characteristic of board engagement in quality improvement and patient safety identified by the Executive Quality Improvement Survey?The board receives a formal quality-performance- measurement report.

    There is a high level of interaction between the board and the medical staff on quality strategy.

    The senior executives’ compensation is based in part on quality performance.

    The board sets clear policies and procedures to guide the medical staff.

2 points

QUESTION 5

  1. Duty of care requires the board to make responsible and informed decisions on behalf of the organizationTrue

    False

2 points

QUESTION 6

  1. Duty of obedience is the obligation to further the purposes of the organization as set forth in its articles of incorporation or bylaws.True

    False

2 points

QUESTION 7

  1. Medical malpractice, a professional-liability subset of negligence law, has never been criticized on the grounds of inefficiency and poor distributionTrue

    False

2 points

QUESTION 8

  1. Medical malpractice is the longest- standing social- incentive structure that attempts to promote safety in healthcare delivery and represents an ethos of individual responsibilityTrue

    False

2 points

QUESTION 9

  1. Which of the following best describe Enterprise Risk Management?Enterprise risk management is a comprehensive process which evaluates all risk exposures confronting an organization from the top down.

    Enterprise risk management is a process, effected by an entity’s board of directors, management and other personnel, applied in strategy setting and across the enterprise, designed to identify potential events that may affect the entity, and manage risks to be within its risk appetite

    Enterprise risk management process is a broad- based discipline requiring the active involvement of all in healthcare and has risk identification and analysis, risk prioritization, and the implementation and monitoring of risk mitigation initiatives at its core.

    Enterprise risk management is an enterprise- wide process designed to identify potential events that may affect the entity, determine the enterprise’s appetite for risk, and manage the event risk according to enterprise objectives.

    All of the above.

2 points

QUESTION 10

  1. Which of the following best define Financial Risk?The business of health care is the delivery of care that is safe, timely, effective, efficient, and patient-centered within diverse populations.

    These risks affect the profitability, cash position, access to capital or external financial ratings through business relationships, or the timing and recognition of revenue and expenses.

    Risks associated with brand and reputation, business strategy, and failure to adapt to a changing healthcare environment, changing customer priorities, and competition.

    Refer to the organization’s most valuable asset: its workforce. This is an explosive area of exposure in today’s tight labor and economic markets

2 points

QUESTION 11

  1. Which of the following best define Operational Risks?The business of health care is the delivery of care that is safe, timely, effective, efficient, and patient centered within diverse populations.

    These risks affect the profitability, cash position, access to capital or external financial ratings through business relationships, or the timing and recognition of revenue and expenses.

    Risks associated with brand and reputation, business strategy, and failure to adapt to a changing healthcare environment, changing customer priorities, and competition.

    Refer to the organization’s most valuable asset: its workforce. This is an explosive area of exposure in today’s tight labor and economic markets

2 points

QUESTION 12

  1. The Sarbanes– Oxley Act of 2002 (SOX) requires management of public companies, both large and small, to annually assess and report on the effectiveness of internal control over financial reporting.True

    False

2 points

QUESTION 13

  1. Which of the following best define Benchmarking?Allows risk managers or healthcare organizations to look outside their own setting to identify best performers in the industry. When processes are to be evaluated, healthcare organizations may wish to look outside the healthcare industry to identify other service providers who have excelled at the same or similar function.

    Collect only data elements from within their own organization. The data can be analyzed after the first data collection to identify best performers at the unit or department levels.

    Process of collecting and analyzing data to identify trends in performance and, when compared with other collectors of the same data, identifying best performers and determining if interventions that were introduced to address identified problems yielded the desired results.

    All of the above

2 points

QUESTION 14

  1. Which of the following best define Internal Benchmarking?Allows risk managers or healthcare organizations to look outside their own setting to identify best performers in the industry. When processes are to be evaluated, healthcare organizations may wish to look outside the healthcare industry to identify other service providers who have excelled at the same or similar function.

    Collect only data elements from within their own organization. The data can be analyzed after the first data collection to identify best performers at the unit or department levels.

    Process of collecting and analyzing data to identify trends in performance and, when compared with other collectors of the same data, identifying best performers and determining if interventions that were introduced to address identified problems yielded the desired results.

    All of the above

2 points

QUESTION 15

  1. Which of the following best define External or Competitive Benchmarking?Allows risk managers or healthcare organizations to look outside their own setting to identify best performers in the industry. When processes are to be evaluated, healthcare organizations may wish to look outside the healthcare industry to identify other service providers who have excelled at the same or similar function.

    Collect only data elements from within their own organization. The data can be analyzed after the first data collection to identify best performers at the unit or department levels.

    Process of collecting and analyzing data to identify trends in performance and, when compared with other collectors of the same data, identifying best performers and determining if interventions that were introduced to address identified problems yielded the desired results.

    All of the above.

2 points

QUESTION 16

  1. Which of the following are the claims data collected as part of the benchmarking process aggregated to establish rates?Number of incidents per year.

    Number of potentially compensable events.

    Number of claims per year.

    All of the above.

2 points

QUESTION 17

  1. Benchmarking is risk management can be both a challenging and exciting activity, yielding valuable information that can provide direction to the organization.True

    False

2 points

QUESTION 18

  1. Which areas could Risk Managers add value to the administration of Workers Compensation?Risk Financing

    Loss Prevention

    Loss Mitigation

    Claims Administration

    All of the above

2 points

QUESTION 19

  1. Claims Administration: handling workers’ compensation claims bears some resemblance to handling professional-liability or general- liability claims, except fewer issues are subject to dispute and the payments are controlled by statutory schedules. The extensive medical knowledge gained from professional liability claims becomes very beneficial in workers’ compensation because most issues are resolved by medical opinion.True

    False

2 points

QUESTION 20

  1. Loss Mitigation: Reducing the accidents giving rise to workers’ compensation claims can be incorporated easily into the risk manager’s role. Given the volume of workers’ compensation incidents, it is usually possible not only to analyze the loss history to pinpoint likely sources of problems but also to demonstrate improvements using the loss data.True

    False

2 points

QUESTION 21

  1. Which of the followings is NOT one of the 10 events on the National Quality Forum’s “never-events” list?Objects left in the body during surgery

    Mismatched blood transfusion

    Air embolism

    Cancer

2 points

QUESTION 22

  1. Is Vascular-catheter- associated infections one of the 10 events on the National Quality Forum “never-events” list?True

    False

2 points

QUESTION 23

  1. Obstetrics and Neonatology, Anesthesia and Emergency Medicine were those clinical areas given early risk modification efforts because:Patients were often highly vulnerable to errors.

    Providing care required or was supplemented by the use of complex technology.

    The injuries suffered were significant and often deadly.

    A and B only

    All of the above

2 points

QUESTION 24

  1. A high-reliability organization (HRO) is a complex high-hazard organization that is prone to unexpected error or injury.True

    False

2 points

QUESTION 25

  1. The platform for patient safety and the rationality of promoting a culture of high reliability is predicated on multiple important competencies:The ability to reinforce the systems and structures to promote safety based on evidence drawn from the science of safety.

    The ability to create a culture that develops and supports those who provide care and services to allow for greater capacity for teamwork, risk awareness, risk mitigation, and resiliency.

    The ability to focus and align resources to create and promote advancements in safety.

    The commitment to assure that evidence-based, patient-centered and system-centered work is done.

    All of the above

2 points

QUESTION 26

  1. Which of the following states the concept that reduces the probability of accident and harm?Health care is a complex system, and complex systems are inherently risk-prone, particularly operating rooms, intensive care units, and emergency rooms.

    People, no matter how competent and vigilant, are fallible because they are human and therefore physically and psychologically limited in memory capacity and the ability to deal with simultaneous multiple cognitive demands.

    People create safety by defending against risk and intercepting error before it reaches the patient.

    Safety is a system and can pose threats of failure from inadequate or clumsy equipment, fatigue- inducing schedules, flawed or incomplete procedures, excessive incentives for production, and risk-prone professional and organizational cultures often associated with faulty communications.

    All of the above.

2 points

QUESTION 27

  1. Which of the following are safety principles from industry to incorporate into daily work?An employee- training process that trains staff in effective teamwork, decision making, risk awareness, and error management.

    Policies and procedures that simplify and standardize work processes and products.

    A commitment to designing self-correcting systems or redundant systems.

    Systems and processes that reduce reliance on human memory through protocols, checklists, and automated systems.

    All of the above.

2 points

QUESTION 28

  1. Which of the following are generally the most common allegations of malpractice problems associated with emergency medicine related to a failure to diagnose?Fractures

    Myocardial Infarctions

    Complications of lacerations, including tendons and nerves

    Foreign bodies in wounds

    All of the above.

2 points

QUESTION 29

  1. Which of the following is considered Primary Allegations Arising out of Obstetric Neonatal Care?Infant neuromuscular development problems

    Maternal hemorrhage

    Maternal or infant death

    Delay in failure to treat fetal distress–delayed Cesarean section

    All of the above

2 points

QUESTION 30

  1. The most frequent allegations related to surgery are:Postoperative complications, including death

    Inadvertent acts and Inappropriate procedures

    Unnecessary surgery and Retained foreign bodies

    d. Postoperative infection

    All of the above

2 points

QUESTION 31

  1. Informed Consent is not important when discussing risk management in surgery and anesthesia.True

    False

2 points

QUESTION 32

  1. Which of the following is an example of engineered patient safety practice?Requiring computerized physician order entry

    Mandating pre-procedure “time-outs” and checklists

    Communication tools including situation background analysis recommendation

    The use of approved and restricted abbreviation lists for clinical documentation

    All of the above

2 points

QUESTION 33

  1. Lean organizations see that every problem and cause of variation, whether a highly visible severe harm event must be addressed to prevent the problem from becoming a severe harm.True

    False

2 points

QUESTION 34

  1. Which of the following is one of the Applicability to Risk Management?Prevention of adverse events

    Mitigation of outcomes

    Reduction of claim likelihood

    A and C

    e. A, B, and C

2 points

QUESTION 35

  1. Which of the following procedures requires Express Consent?Surgery (major/minor)

    Anesthesia

    Radiographic imaging

    Blood, blood product transfusion, and Biopsies

    All of the above

2 points

QUESTION 36

  1. The two principal types of consent are implied consent and expressed consent.True

    False

2 points

QUESTION 37

  1. The implied consent is based on either verbal or written expression from the patient that a proposed course of treatment is acceptable.True

    False

2 points

QUESTION 38

  1. Expressed Consent is based on an unspoken understanding between the treating physician and the patient that a proposed method of treatment is advisable and suitable to both parties.True

    False

2 points

QUESTION 39

  1. Components of clear communication include the ability to speak and write plainly about health information, to effectively use visual aids, to implement teach-back techniques in which patients’ true comprehension is tested, to provide interpreter services when required, and to provide culturally competent care to all patients.True

    False

2 points

QUESTION 40

  1. The Joint Commission Resources published “ Strategies for Addressing Health Care Worker Fatigue” and named education as the foundation of raising awareness and thereby reducing fatigue in the workplace.True

    False

2 points

QUESTION 41

  1. Handoff communication is the contemporaneous, interactive process of passing patient-specific information from one caregiver or team of caregivers to another for the purpose of ensuring the continuity and safety of the patient’s care.True

    False

2 points

QUESTION 42

  1. Which of the followings are elements that should be included in handoff?Interactive communication that allows for the opportunity for questioning between the giver and receiver of patient information

    Up- to- date information regarding the patient’s condition, care, treatment, medications, services, and any recent or anticipated changes.

    An opportunity for the receiver of the handoff information to review relevant patient historical data

    Interruptions during handoffs are limited to minimize the possibility that information fails to be conveyed

    e. All of the above

2 points

QUESTION 43

  1. SBAR stands for Situation, Background, Assessment, and RecommendationTrue

    False

2 points

QUESTION 44

  1. The SBAR system is helpful but does not always meet the criteria needed for a complete and safe handoff.True

    False

2 points

QUESTION 45

  1. The hospital setting most handoff communication policies for nurses include the following:Handoffs must be interactive so that the nurse receiving the patient has the opportunity to question and confirm what is reported.

    There should be minimal interruptions. The content of the report should be objective, concise, and related to the patient’s care.

    Nurses are responsible for all handoff communications to contain specific information such as age, gender, diagnosis, allergies, medications, and code status.

    A and B only

    All of the above

2 points

QUESTION 46

  1. Plan-do-check-act is an approach to systematic process improvement and patient safety promotion.True

    False

2 points

QUESTION 47

  1. There is no fundamental responsibility of the hospital board to the community regarding patient safety or quality care.True

    False

2 points

QUESTION 48

  1. When managing clinical risk, the initiative should include hiring the right staff or offering additional training to current staff.True

    False

2 points

QUESTION 49

  1. The CMS strategy of pay for performance helps place patient safety responsibility on physicians.True

    False

2 points

QUESTION 50

  1. A focus on physician competency and the requirement for medical staff to be active in QA initiatives  can ensure safe, quality care.True

    False