CPHRM Exam Dumps - Certified Professional in Health Care Risk Management (CPHRM)

According to Health Care Risk Management principles supported by ASHRM and the American Hospital Association Certification Center, insurance coverage for liability exposures is often structured in layers. The first layer of insurance that responds to a covered loss is known as the primary policy.

Primary insurance provides initial coverage once any applicable deductible or self-insured retention has been satisfied. It is responsible for defense and indemnity payments up to the policy’s stated per-occurrence and aggregate limits. Only after the primary policy limits are exhausted do excess or umbrella policies respond.

Terms such as baseline, foundation, and frontline are not recognized technical classifications in layered insurance structures. In professional and general liability programs, organizations commonly maintain a primary layer followed by one or more excess layers to protect against catastrophic losses.

Risk financing objectives emphasize understanding policy structure, limits, attachment points, and coordination between layers to ensure adequate protection of organizational assets. Therefore, the correct term for the first layer of insurance that responds to a loss is the primary policy.

According to Health Care Risk Management standards supported by ASHRM and the American Hospital Association Certification Center, The Joint Commission’s sentinel event process requires completion of a thorough root cause analysis and development of a corrective action plan. While various analytical tools such as fishbone diagrams, flowcharts, or Pareto charts may be used to assist in identifying contributing factors, these specific tools are not mandated.

The essential required component is a written action plan that identifies specific improvement steps, assigns responsibility, and includes measurable outcomes and timelines for implementation. The action plan must address root causes and system vulnerabilities, not merely individual performance issues. It should demonstrate how corrective actions will reduce the likelihood of recurrence and include monitoring mechanisms to evaluate effectiveness.

Fishbone diagrams and Pareto charts are optional tools used during analysis but are not explicitly required elements. Similarly, departmental flowcharts may support understanding of processes but are not mandated by The Joint Commission.

Clinical and patient safety objectives emphasize systematic investigation, leadership oversight, and documented improvement efforts following sentinel events. Therefore, a detailed action plan with implementation dates is the required analysis component within the sentinel event process.

Failure Mode and Effects Analysis FMEA is the most appropriate tool in this scenario because it is a proactive risk assessment methodology designed to identify and mitigate potential failures before harm occurs. According to Health Care Risk Management principles outlined by ASHRM and the American Hospital Association Certification Center, FMEA is specifically used when introducing new processes, services, or high-risk clinical operations, such as an anticoagulation clinic involving medications with narrow therapeutic indices and significant bleeding risks.

FMEA systematically evaluates each step in a proposed process, identifies possible failure modes, analyzes their causes and effects, and prioritizes risks using severity, occurrence, and detectability scoring. This structured approach aligns with patient safety objectives by reducing preventable adverse events before implementation.

In contrast, Root Cause Analysis RCA is a retrospective tool used after an adverse event has occurred. A cause and effect diagram is a component often used within RCA or FMEA but is not a comprehensive risk assessment tool on its own. A scatter diagram is primarily used for statistical correlation analysis and does not evaluate process failures.

Therefore, for proactive risk identification and mitigation prior to clinic opening, FMEA is the best and most appropriate tool.

Failing to order or perform an indicated test can represent a diagnostic process failure—an omission that delays recognition of deterioration, leading to harm and escalation of care. Risk management objectives treat diagnostic safety as a systems issue: access to decision support, timely follow-up of abnormal results, clear responsibility for test ordering and review, effective handoffs, and adequate staffing/workload conditions to avoid missed steps. Such errors are often linked to underuse in the IOM quality framework (failure to provide beneficial service) and can drive claims due to preventable worsening. Preventive strategies include standardized pathways, trigger tools for abnormal labs, closed-loop test result management, and teamwork practices that encourage escalation when clinical concern persists despite uncertainty.

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.