Managing Risk 1- Syed Flashcards
_______ is anything that threatens the ability of a person or a organization to accomplish its mission.
Risk
T/F?
Within RISK there is some degree of probability that exposure to a hazard will lead to a negative outcome or consequence.
True
Speculative Risk
a chance of GAIN or benefit as well as LOSS
Pure Risk
ONLY the opportunity of SUSTAINING a LOSS; there is NO opportunity for gain
Name the type of RISK?
A break-in to your pharmacy in which half of your assets are stolen.
INSURABLE (pure) RISK
What is the criteria for insurable risk (6)
- The loss must be MEASURABLE in dollar figures, easy to measure, and result in substantial loss
- The loss must have a DEFINED TIME AND PLACE
- The loss must be ACCIDENTAL for the insured
- The PROBABILITY of the event occurring in a population can be ACCURATELY CALCULATED
- The insured must have an INSURABLE INTEREST
- The insurance PREMIUM must be available for a REASONABLE COST
Developing a RISK Management Strategy involves what 4 things?
- ANALYZE and IDENTIFY strategies to MANAGE THREATS
- ASSESS the THREAT POTENTIAL
- make DECISIONS on MANAGING the risks
- PROTECT the VITAL ASSETS of a pharmacy
What are the 5 steps in the Risk Management Process?
- Establish the CONTEXT
- IDENTIFY and ANALYZE risk
- EVALUATE and PRIORITIZE the risk
- Select an APPROPRIATE risk management STRATEGY and IMPLEMENT the technique
- MONITOR DECISIONS and UPDATE the program
Name the 4 techniques for managing RISK.
APAS
- Risk AVOIDANCE
- Risk PREVENTION /modification
- Risk ABSORPTION/retention
- Risk SHARING or transfer
T/F?
MOST instances of RISK MANAGEMENT will use a combination of risk PREVENTION, ABSORPTION, and SHARING TRANSFER
True
Name the 7 types of PHARMACY INSURANCE.
- Property Insurance
- Liability Insurance
- Business Owner’s Policy
- Individual Professional Liability Insurance
- Key Person Insurance
- Umbrella or Excess Liability
- Worker’s Compensation
What type of pharmacy insurance protects the property and physical assets?
Property Insurance
T/F?
PROPERTY INSURANCE is also called Causality Insurance.
False
-LIABILITY INSURANCE
______ insurance protects against claims when it is sued for damages or injuries caused by negligence of the business or its employees and is also called CAUSALITY INSURANCE.
Liability Insurance
What type of pharmacy insurance is composed of a BUNDLE of PROPERTY and LIABILITY insurance for small business owners (less than 100 employees)
Business Owner’s Policy
T/F?
Business Owner’s Policies are for small business owners with employees
TRUE
What type of pharmacy insurance protects individual against claims emanating from actual or alleged errors of omissions, including negligence, in the course of professional duties or activities?
Individual Professional Liability Insurance
________ insurance protects a business from financial loss if key individuals were to die or experience a disability.
Key Person Insurance
________ Liability covers the DIFFERENCE between the BASE LIABILITY and the JUDGEMENT amount.
Umbrella or Excess Liability
Medical expenses, disability incomes, and death benefits to dependents of an employee whose accident, illness or death is job-related describes what type of pharmacy insurance?
Worker’s Compenstation
T/F?
Worker’s Compensation is always required when a small business has it’s own employees and is usually regulated by the state.
True
T/F?
Small business that staff via a temp agency MUST provide Worker’s Compensation.
False
- the temp agency is responsible for Worker’s Compensation
T/F?
If all pharmacy staff are OWNER’S, Workers Compensation is NOT required.
True
Name the 4 emerging risks associated with modern pharmacy practice.
- OBRA 1990
- HIPPA 1996
- Information Technology (Related/Digital Risk)
- Electronic Medical Records and e-Prescribing
The Omnibus Budget Reconciliation Act of 1990 (OBRA 1990)- 3
- Previous duty to warn resided with the prescribing physician
- Prospective DUR and patient counseling
- 9% of pharmacy claims are drug review claims
The Health Insurance Portability and Accountability Act of 1996 (HIPPA 1996)- 3
- Conducts risk assessments
- Appoints security and privacy officers (compliance officers)
- Implement policies and procedures
T/F?
OBRA 1990 Protects all “individually identifiable health information”.
False
HIPPA 1996
T/F?
If there is an URGENT need then an exception to HIPPA can be made. i.e. POLICE INVESTIGATIONS
True
What 4 types of risk are associated with INFORMATION TECHNOLOGY.
- STRATEGIC RISK
- PERFORMANCE RISK
- System requirements
- Modularity - OPERATIONAL RISK
- PSYCHOLOGICAL RISK
All of the following are examples of ______ Risk (Information technology)
- Internal fraud
- External fraud
- Computer homicide
- Digital veil
- The human–automation trade-off
- System failures
Operational Risk
T/F?
Risk is defined as a negative outcome or the CAUSE for a negative outcome.
True
What 2 ways can RISK be assessed?
- Quantitatively
- Qualitatively
Quantitative Approach (2)
- Doesn’t divide events into causes and outcomes explicitly
- Probability is assigned to each possible relationship whose development is undesirable
Qualitative Approach (3)
- Provides a better understanding of both cause and outcome
- Identification of causes and predictions of outcomes is better
- Identification of outcomes and predicting causes to minimize risk is harder
Standards for pharmacist are derived from _____ and _____ standards and values.
LAWS and PROFESSIONAL
T/F?
Violations of pharmacist standards can affect the licensure status of pharmacies and pharmacist.
True
Violations from laws and professional standards and values can result in what 2 things?
- Litigation (an action in court to enforce a particular right)
- Criminal prosecution
Laws and professional standards and values consist of what 2 things?
- statues and regulations
- professional codes of ethics
T/F?
Authority to regulate foods and drugs sold in interstate commerce was given by the STATE
False
-US Constitution
Drug Importation Act of 1848 (2)
- Was the only federal law regulating drugs until the 20th century
- Empowered the US Customs Service to prevent the importation of adulterated drugs from other countries
What was prompted by the publication of The Jungle?
Pure Food and Drug Act of 1906
Purpose of the food and Drug Act of 1906
“for preventing the manufacture, sale or transportation of adulterated or mis-branded or poisonous or deleterious foods, drugs, medicines, liquors, and for regulating traffic therein”
________ required foods and drugs to be HYGIENIC, ACCURATELY LABELED, but DID NOT require drugs to be SAFE.
The Pure Food and Drug Act of 1906
_____ was preceded by the Elixir Sulfanilamide tragedy of 1937 and required PREMARKETING SAFETY testing.
The Food, Drug and Cosmetic Act of 1938 and Amendments
1951 Durham-Humphrey Amendment (2)
created 2 categories:
- RX only category
- OTC drugs
1962 Kefauver-Harris Amendments (3)
- Preceded by the Thalidomide tragedy of the 1960s
- Testing both SAFETY and PROOF OF EFFICACY
- Well-controlled clinical trials.
What ACT says that pharmacies may not stock, possess, or sell any prescription drug samples?
Prescription Drug Marketing Act of 1987 (prohibits the diversion of rx drug samples into the retail market sector)
OBRA 1990
In order to receive federal monies, states participating in Medicaid had to establish standards for what 3 things?
- Maintaining proper patient records
- Prospective drug use review (pro-DUR)
- Patient counseling
T/F Employee training programs, education, and established policies and procedures are essential to manage risk.
TRUE
the scope (extent) of protection provided under an insurance contract
coverage
a provision that requires the insured party to share some of the costs of covered services/losses on a fixed percentage basis
coinsurance
a type of health insurance that provides MONTHLY INCOME to the policy holder if s/he become unable to work b/c of an illness or accident
disability insurance
individual responsibility for causing injury to another person or damage to another’s property through negligence
liability
failure to use reasonable care
negligence
insurance terminology for risk, possible cause of injury, or event causing damage or loss
peril
term used to describe a document that amends or changes the original policy
rider
a form of insurance protection in excess of the amount covers by other liability insurance policies
umbrella liability (covers the difference between the BASE LIABILITY and the JUDGMENT AMOUNT)
______ was the first state in 1870 to enact a state pharmacy practice act
Rhode Island
What did the state pharmacy practice act establish? (2)
- conduct of pharmacies and ancillary staff
- physical facilities licensed as pharmacies
T/F Most states extended standards to benefit ALL patients, not just Medicaid
TRUE
HIPAA is an amendment to what act?
Social Security Act
T/F The prescription drug marketing act of 1987 Restricts the annual distribution of prescription drugs by pharmacies to other pharmacies to no more than 5% of the annual dollar value of prescription drug sales for the distributing pharmacy.
TRUE
State Prescription Drug Monitoring Programs are used to help….
curb the practice of “doctor shopping”
Collect information on controlled substances and “drugs of concern” dispensed within the state and maintain an electronic database of the information
State Prescription Drug Monitoring Program
based on precedent established by the outcomes of previous civl cases
case law
deals with how to reduce and manage exposure to risk
risk management
T/F One approach to ensure minimum legal standards are met is by setting up programs to foster performance improvement
TRUE
