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ASHRM Certified Professional in Health Care Risk Management (CPHRM) Sample Questions (Q98-Q103):

NEW QUESTION # 98
Which of the following should a risk manager consider when evaluating the effectiveness of a claims management program?
* indemnity-to-expense ratios
* total number of cases reported
* percentage of cases resolved within reserves
* percentage of cases identified prior to claim

A. 2, 3, and 4 only
B. 1, 2, and 3 only
C. 1, 3, and 4 only
D. 1, 2, and 4 only

Answer: C

Explanation:
According to Health Care Risk Management principles outlined by ASHRM and the American Hospital Association Certification Center, evaluation of a claims management program focuses on efficiency, financial accuracy, and proactive identification of risk exposures.
Indemnity-to-expense ratios are important performance indicators that measure the proportion of funds spent on compensation versus defense costs. A balanced ratio reflects efficient claim handling and appropriate litigation management. The percentage of cases resolved within reserves evaluates the accuracy of initial reserve setting and ongoing claims assessment, demonstrating financial forecasting effectiveness.
Additionally, the percentage of cases identified prior to formal claim filing reflects proactive risk identification and early intervention practices, which may reduce litigation costs and improve resolution outcomes.
In contrast, the total number of cases reported alone does not measure program effectiveness, as volume may be influenced by patient population, service lines, or reporting culture rather than management quality.
Claims and litigation objectives emphasize accurate reserving, early case identification, and cost-effective resolution strategies. Therefore, indemnity-to-expense ratios, resolution within reserves, and early case identification are appropriate metrics for evaluating the effectiveness of a claims management program.

NEW QUESTION # 99
An appropriate way to complete the verification read-back of a complete order, as required by The Joint Commission National Patient Safety Goals, is to have the person receiving the order

A. have a witness verify that the information is repeated back correctly.
B. document the date and time the order was received.
C. immediately repeat the information.
D. write the information down before reading it back.

Answer: D

Explanation:
According to Health Care Risk Management standards supported by ASHRM and The Joint Commission National Patient Safety Goals, the read-back process is designed to ensure accurate communication of verbal or telephone orders. The correct process requires the person receiving the order to first write down the complete order and then read it back to the prescribing practitioner for verification.
Writing the order down before reading it back reduces reliance on memory and decreases the risk of omission or transcription errors. The practitioner who gave the order must then confirm that the read-back is accurate.
This closed-loop communication process enhances patient safety and reduces medication and treatment errors associated with miscommunication.
Immediately repeating the information without documenting it does not meet the full verification requirement, as the written record must be confirmed. A witness is not required under the standard. Documenting the date and time is necessary for proper charting but does not constitute completion of the read-back verification itself.
Clinical and patient safety objectives emphasize clear, structured communication processes. Therefore, writing the information down before reading it back is the appropriate method to complete the verification process.

NEW QUESTION # 100
Root Cause Analyses most often reveal that mistakes are a result of:

A. A single reckless person in most cases
B. Random chance with no patterns
C. A series of small events and system flaws aligning
D. Only equipment malfunction

Answer: C

Explanation:
RCA and systems safety models (e.g., Swiss Cheese) emphasize that adverse events typically requiremultiple contributing factors-small process breakdowns, latent conditions, and active failures-to align. This is why focusing only on the last person who touched the patient ("sharp end blame") rarely prevents recurrence. Risk management objectives are to identify and strengthen defenses: policies, training, equipment design, staffing models, communication standards, and redundancy where needed. A series-of-events understanding enables targeted corrective actions (forcing functions, standardization, automation with safeguards, independent double checks for high-alert processes). It also supports just culture: accountability is preserved for reckless behavior, but most improvement comes from redesigning systems that make errors more likely. This approach improves reliability, reduces repeat harm, and provides defensible evidence of organizational learning and corrective action.

NEW QUESTION # 101
According to The Joint Commission, which of the following should be done to patient-owned electrical devices entering the facility?

A. conduct an electrical safety inspection
B. tag by biomedical engineering
C. sequester the electrical device
D. inventory with patient belongings

Answer: A

Explanation:
According to Health Care Risk Management standards supported by ASHRM and accreditation guidance from The Joint Commission, patient-owned electrical devices brought into healthcare facilities must be evaluated to ensure they do not pose safety risks. The Joint Commission's Environment of Care standards emphasize electrical safety, fire prevention, and reduction of hazards within patient care areas.
Before a patient-owned electrical device is used within the facility, an electrical safety inspection should be conducted to assess the integrity of cords, plugs, grounding, and overall condition. The purpose is to identify potential risks such as frayed wiring, overheating hazards, or improper voltage compatibility that could endanger patients, staff, or equipment.
Simply inventorying the device with personal belongings does not address safety concerns. Sequestering the device may be appropriate if it fails inspection, but routine confiscation is not required. While biomedical engineering departments often assist with inspections, tagging by biomedical engineering is not itself the required action; the essential requirement is that a safety inspection be performed.
Clinical and patient safety objectives emphasize proactive hazard identification and compliance with accreditation standards. Therefore, conducting an electrical safety inspection is the appropriate action for patient-owned electrical devices entering the facility.

NEW QUESTION # 102
When a hospital notes that most errors are occurring at the "sharp end," what does that mean?

A. Errors are occurring in billing and contracting
B. Errors occur during direct caregiver-patient interaction (frontline care)
C. Errors occur only in device manufacturing
D. Errors are exclusively leadership decisions

Answer: B

Explanation:
The "sharp end" refers to the point in a system where clinicians directly interact with patients and deliver care-nurses administering medications, physicians performing procedures, therapists mobilizing patients, and so on. Errors at the sharp end are typicallyactive failuresthat are immediately visible, but they are often shaped by "blunt end" factors-staffing levels, training, equipment design, policies, and workflow constraints. Risk management objectives discourage blaming the sharp end alone; instead, they use incident analysis (RCA) to identify latent system conditions that make frontline errors more likely. Improving sharp- end safety includes standardization, teamwork tools (SBAR/TeamSTEPPS), human factors engineering, and reducing hazardous variability in processes. This systems approach helps prevent repeat events and supports a just culture where learning is prioritized while accountability is preserved for reckless conduct.

NEW QUESTION # 103
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