HEALTHCARE QUALITY IMPROVEMENT
AND RISK MANAGEMENT EXAM WITH
CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
LATEST ALREADY GRADED A+ 2025 – 2026
Root Cause Analysis (RCA) - ANSWERS-determines
underlying cause of adverse events; used after incident to
uncover primary cause
-1 event; after; reactive
Failure Mode and Effects Analysis (FMEA) - ANSWERS-a
systematic process for identifying potential design and
process failures before they occur, with the intent to
eliminate them or minimize the risk associated with them
-holistic approach and before; proactive
,external evaluation - ANSWERS--A surveyor from the Joint
Commission for the Accreditation
-evaluation by insurers/underwriters; underwriters are
concerned about credentialing, peer review, screening
systems, compliance with TJC
-benchmarking with other companies
claims experience - ANSWERS-risk managers should have
date of loss, closing date, evaluation of allegations, date of
notice, nature of the injury, who was involved, final
disposition
Cost of Risks - ANSWERS--hazard risks
-operational risks
-financing risks
-strategic risks
high exposure in health care - ANSWERS--clinical activities
-monitoring
-medical records
-electronic health records
-health insurance portability and accountability act (HIPAA)
,-credentialing
-withholding of treatment
-disclosure
CHAPTER 7 - ANSWERS-
authorities with jurisdiction - ANSWERS-local health
department, fire department, local buildings or zoning
department
Accreditation - ANSWERS-granting approval or belief in a
school
-"deemed status"
Conditions of Participation - ANSWERS-The standards that
govern providers receiving Medicare and Medicaid
reimbursements
-"environment of care": safety and security hazardous
materials and waste, fire prevention, medical equipment,
utilities management, and emergency management
, risk red flags - ANSWERS--treatment conditions: poor
treatment results, repetition of the problem, lack of follow-
up care, and equipment malfunction
-patient relations: dissatisfied patient, antagonistic patient
or family members, complaining relatives, patient
discharged against medical advice, intimidated patient, poor
physician-patient relationship, and poor staff-patient
relationship
-practice management: poorly maintained medical records,
lack of critical policies and procedures, and excessive
volume of patients
-conduct of staff: acting outside the scope of training, lack of
qualification, performance of a procedure for the first time
without supervision, outspoke or rude behavior, personality
conflict, and poor physician-staff relationship
Risk management tools - ANSWERS--incident reporting
-occurrence reporting
-occurrence screening
Incident Reporting - ANSWERS--identifying of events that
were not consistent with the routine operation of the
hospital or the routine care of particular patients or visitors
AND RISK MANAGEMENT EXAM WITH
CORRECT ACTUAL QUESTIONS AND
CORRECTLY WELL DEFINED ANSWERS
LATEST ALREADY GRADED A+ 2025 – 2026
Root Cause Analysis (RCA) - ANSWERS-determines
underlying cause of adverse events; used after incident to
uncover primary cause
-1 event; after; reactive
Failure Mode and Effects Analysis (FMEA) - ANSWERS-a
systematic process for identifying potential design and
process failures before they occur, with the intent to
eliminate them or minimize the risk associated with them
-holistic approach and before; proactive
,external evaluation - ANSWERS--A surveyor from the Joint
Commission for the Accreditation
-evaluation by insurers/underwriters; underwriters are
concerned about credentialing, peer review, screening
systems, compliance with TJC
-benchmarking with other companies
claims experience - ANSWERS-risk managers should have
date of loss, closing date, evaluation of allegations, date of
notice, nature of the injury, who was involved, final
disposition
Cost of Risks - ANSWERS--hazard risks
-operational risks
-financing risks
-strategic risks
high exposure in health care - ANSWERS--clinical activities
-monitoring
-medical records
-electronic health records
-health insurance portability and accountability act (HIPAA)
,-credentialing
-withholding of treatment
-disclosure
CHAPTER 7 - ANSWERS-
authorities with jurisdiction - ANSWERS-local health
department, fire department, local buildings or zoning
department
Accreditation - ANSWERS-granting approval or belief in a
school
-"deemed status"
Conditions of Participation - ANSWERS-The standards that
govern providers receiving Medicare and Medicaid
reimbursements
-"environment of care": safety and security hazardous
materials and waste, fire prevention, medical equipment,
utilities management, and emergency management
, risk red flags - ANSWERS--treatment conditions: poor
treatment results, repetition of the problem, lack of follow-
up care, and equipment malfunction
-patient relations: dissatisfied patient, antagonistic patient
or family members, complaining relatives, patient
discharged against medical advice, intimidated patient, poor
physician-patient relationship, and poor staff-patient
relationship
-practice management: poorly maintained medical records,
lack of critical policies and procedures, and excessive
volume of patients
-conduct of staff: acting outside the scope of training, lack of
qualification, performance of a procedure for the first time
without supervision, outspoke or rude behavior, personality
conflict, and poor physician-staff relationship
Risk management tools - ANSWERS--incident reporting
-occurrence reporting
-occurrence screening
Incident Reporting - ANSWERS--identifying of events that
were not consistent with the routine operation of the
hospital or the routine care of particular patients or visitors
