Risk Management Flashcards

1
Q

Define risk and identify its role in pharmacy practice.

A
  • “Anything that threatens the ability of a person or organization to accomplish its mission”
  • ## Pharmacists should be aware of risks and how to manage them
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2
Q

relationship between risks and threats

A
  • Risk becomes a threat when there is a probability that a negative outcome will occur after exposure to a hazard
  • Non-exposure to a hazard diminishes or eliminates threat
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3
Q

What are the types of risks?

A
  • Speculative

- Pure

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4
Q

Speculative risks

A
  • Chance of benefit or loss, individual decides on amount of risk willing to assume (willing to lose)
  • not insurable
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5
Q

Pure risks

A
  • Accidental, unanticipated, or unavoidable

- insurable

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6
Q

Identify the criterias for determining an insurable risk.

A
  • Loss must be measurable in dollar figures
  • Loss must be substantial
  • Probability of event occurring in population can be accurately calculated
  • Sufficiently large number of homogenous individuals with similar risks to make losses predictable
  • Insured must have an insurable interest
  • Insurance premium must be available for a reasonable cost
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7
Q

Identify the steps in the risk management process

A
  • Establish the context
  • Identify and analyze risks
  • Evaluate and prioritize risks
  • Select a strategy and implement
  • Monitor update the program
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8
Q

Identify the steps in the risk management process: Establish the context questions to ask

A
  • What are the goals of the risk management process?
  • What are potential vulnerabilities of the business?
  • Do employees or patients risk injuries?
  • How might the reputation of the business/organization suffer due to a negative outcome?
  • Could providing certain goods or services avoid costly negative outcomes?
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9
Q

Identify the steps in the risk management process: Identify and analyze risks specific to pharmacies

A
  • Filling prescriptions
  • Counseling
  • Deliveries
  • Building maintenance
  • Sterile compounding
  • Technology
  • HIPAA
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10
Q

Identify the steps in the risk management process: Evaluate and prioritize risks

A

Risks with greatest potential for substantial loss should be prioritized first

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11
Q

Identify the steps in the risk management process: Select a strategy and implement

A
  • Determine which risks should be avoided
  • Develop policies and procedures
  • Secure necessary insurance policies and riders
  • Consult with specialists for further advice – attorney, accountant, consultant
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12
Q

What is a rider?

A

supplemental policies that provide additional coverage for something not included in additional policy for additional charge

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13
Q

Identify the steps in the risk management process: Monitor update the program

A
  • Necessary to meet new challenges, threats, and opportunities
  • Continuous quality improvement
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14
Q

Identify the appropriate techniques in managing risks.

A
  • Risk Avoidance
  • Risk Prevention / Modification
  • Risk Absorption / Retention
  • Risk Sharing / Transfer
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15
Q

Identify the appropriate techniques in managing risks: Risk Avoidance

A
  • Avoid the risk

- Sometimes impractical

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16
Q

Identify the appropriate techniques in managing risks: Risk Prevention / Modification

A
  • Smoke alarms
  • Security systems
  • Computer software
  • Policies and Procedures
  • Employee training and development
17
Q

Identify the appropriate techniques in managing risks: Risk Absorption / Retention

A
  • Accepting losses (ex. shoplifting, expired inventory, unsold front end merchandise)
  • Insurance deductibles – higher in exchange for lower premiums
  • Absorbing cost of risk altogether – opt out of insurance
18
Q

Identify the appropriate techniques in managing risks: Risk Sharing / Transfer

A
  • Insurance

* Often used in conjunction with risk prevention (Ex: Smoke alarm in conjunction with fire insurance)

19
Q

What are the common insurance terms?

A
  • Premium
  • Deductible
  • Coinsurance
  • Copayment
  • Out-of-pocket maximum
20
Q

Premium

A

amount you pay for health insurance every month

21
Q

Deductible

A

amount you pay for covered health care services before your insurance plan starts to pay

22
Q

Coinsurance

A

% of costs you pay after you’ve paid your deductible

23
Q

Copayment

A

fixed amount you after you’ve paid your deductible

24
Q

Out-of-pocket maximum

A

the maximum you have to pay for covered services in a plan’s year

25
Q

Identify IT-related risks that are emerging in modern pharmacy practice.

A
  • Strategic Risk
  • Performance Risk
  • Operational Risk
  • Psychosocial Risk
  • Electronical Medical Records (EMRs) and E-Prescribing
26
Q

IT-related risks: Strategic Risk

A
  • Pharmacies should assess compatibility of technology with their mission and goals
  • New technology may be incompatible with existing technology of other parties
  • Employees should be provided appropriate training of new technology
27
Q

IT-related risks: Performance Risk

A
  • Degree of uncertainty in technology that may keep the system from being suitable for its intended use
  • Varies with needs and desires of pharmacy
  • Arises from product complexity – number of components, functions, and interfaces in a system
28
Q

IT-related risks: Operational Risk

A
  • Risk of loss resulting from inadequate or failed internal processes, people and systems, or external events
  • Characterized by six event factors: Internal fraud, External fraud, Computer homicide, Digital veil, Human Automation trade-off, System failures
29
Q

IT-related risks: Psychosocial Risk

A
  • Safety and health hazards posed by technology in workplace
  • Consequences: increased worker’s compensation costs, absenteeism, disability, decreased productivity
  • Cumulative trauma disorders: injuries due to repetitive motions: Carpal tunnel syndrome, Neck / shoulder / back pain, irritability, headaches difficulty sleeping, eye strain, deteriorated vision
30
Q

IT-related risks: Electronical Medical Records (EMRs) and E-Prescribing

A
  • Goal – increased patient safety and efficiency
  • Concerns over security of patient health information (PHI)
  • Encrypt data on mobile devices
  • Require two-factor authentication for remote access
  • DEA requirements for security for physicians that wish to e-prescribe controlled substances
31
Q

IT-related risks: Operational Risk: External fraud

A
  • Act committed by a third party that leads to data theft, data loss, and/or functional disruption
  • Information attack
  • Business-function attack
32
Q

IT-related risks: Operational Risk: Computer homicide

A

Use of IT systems to perform a malicious act that results in the death of a patient

33
Q

IT-related risks: Operational Risk: Computer homicide

A

Use of IT systems to perform a malicious act that results in the death of a patient

34
Q

IT-related risks: Operational Risk: Digital veil

A
  • Use of computer and automated machinery leads to complacency in employees and blind trust of automation
  • “Alert fatigue”
35
Q

IT-related risks: Operational Risk: Human Automation trade-off

A
  • Years of experience and situational factors cannot be incorporated into software
  • Technology less capable in dealing with emergency situations
  • No “robot” for clinical judgment
36
Q

IT-related risks: Operational Risk: System Failures

A
  • If one function crashes, potential for cascading effect that causes other services to fail
  • Many services (refill requests, insurance processing, inventory management) rely on internet
  • Corruption of a database for a large chain