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

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 _____.

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?

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

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

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

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

Which force influences the growth of risk management?

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

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

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?

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

Which is an issue associated with HIPAA security?

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

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

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

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

With regard to importance, an incident report is _____.

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

A risk manager would typically have a _____ background.

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