Performance Improvement Practice Test 1
Performance Improvement NCLEX Practice Test
Performance Improvement, within the NCLEX test plan under Safe and Effective Care Environment → Management of Care, reflects the core knowledge domains and conceptual competencies directly related to what the exam evaluates. The targeted number of questions is 50; designed with realistic clinical scenarios and conceptual variety to help you identify both your strengths and improvement areas.
This test is the 1st part of the Performance Improvement section. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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In the Performance Improvement Study Cards section, shared by real NCLEX candidates, you’ll find concise summaries and high-yield insights related to the most tested concepts. It’s a perfect space to reinforce challenging topics and sharpen your recall through quick, focused repetitions. Short, powerful, and repeatable!
Performance Improvement Practice Test 1
"SWOT" analysis refers to?
- Strength, weakness, observation and threat
- Strength, weakness, opportunities, threat
- Strength, weakness, opportunities and techniques
- Strength, weakness, observation and techniques
Explanation: Answer reason: SWOT analysis is a structured planning tool used to evaluate an organization’s internal strengths and weaknesses, along with external opportunities and threats. It helps guide decision-making, strategic planning, and quality improvement.
The new graduate nurse interviews for a position in a large healthcare agency that has shared governance. Which of the following best demonstrates shared governance in the nursing department?
- A board is appointed to oversee administrative decisions.
- Departments share responsibility for quality client care.
- Staff groups are appointed to discuss practice and education.
- Non-nurse managers supervise nursing staff in all units.
Explanation: Answer reason: Shared governance empowers nurses through participation in decision-making councils that influence practice, education, and quality initiatives.
Barriers to evidence-based practice include all of the following except?
- Higher workload
- Lack of knowledge
- Lack of scientific literature
- Lack of skills in conducting computer-based literature
Explanation: Answer reason: Scientific literature is abundant; the main barriers are limited time, lack of skills, and knowledge deficits. Thus, “lack of scientific literature” is not a valid barrier.
The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the "unfreezing" phase of change. The nurse manager should INITIALLY?
- Plan how to deal with defensive staff behavior
- Explain to staff why the change is necessary
- Help staff accept the new change
- Work with staff to internalize the changes
Explanation: Answer reason: In Lewin’s “unfreezing” stage, the first action is creating awareness by explaining the need for change and why the current situation cannot remain. This reduces resistance and prepares staff psychologically.
A medication error occurred when two IV antibiotics with similar packaging were stored next to each other. During the root cause analysis, which statement by the nurse reflects correct RCA thinking?
- “The nurse who made the mistake should be written up immediately.”
- “Errors happen; there’s no need to investigate further.”
- “We need to look at how the storage system contributed to the error.”
- “Next time the nurse should just be more careful.”
Explanation: Answer reason: Root cause analysis focuses on **system factors**, not individual blame. Identifying environmental, workflow, or process issues prevents future errors more effectively than punishing individuals.
A nurse notices that a high-risk medication was almost given to the wrong patient, but the mistake was caught during the two-identifier check. How should the nurse classify this event?
- As a sentinel event requiring immediate facility shutdown
- As a near-miss that should still be reported to improve systems
- As an insignificant event that does not need documentation
- As patient negligence because the client did not speak up
Explanation: Answer reason: Near-miss events **did not reach the patient**, but they still reveal system vulnerabilities and MUST be reported to prevent an actual future event. They are valuable for quality improvement.
A unit is experiencing delays in patient discharge paperwork. The nurse manager decides to use the PDSA model. What is the correct first step?
- Study the outcomes from last month’s discharge delays
- Create a full policy change for the entire hospital
- Identify the problem and design a small test change before implementing it broadly
- Implement the new process on all units at once
Explanation: Answer reason: The first step of PDSA is **Plan**—define the issue and design a small-scale trial. Full-scale rollout comes only after studying results and refining the process.
A client slipped on water near the sink but did not fall or sustain injury. The nurse cleans the spill and prepares an incident report. Which information is most appropriate to include?
- “Client was careless and didn’t watch where they were going.”
- “Client almost fell because the unit was understaffed today.”
- “Clear water was present on the floor; client reported losing balance but remained unharmed.”
- “I believe housekeeping failed to do their job correctly.”
Explanation: Answer reason: Incident reports must contain **objective, factual observations**—no blame, no assumptions, and no emotional wording. Only what was seen and heard should be documented.
A nurse notices repeated delays in obtaining morning lab draws because transport staff arrive late. What is the most appropriate first step in addressing this workflow issue?
- Bring the concern to the interdepartmental team to review the process
- File individual complaints against the transport staff
- Assign nurses to perform all lab transport duties instead
- Ignore the issue because labs are eventually completed
Explanation: Answer reason: Workflow problems require **system-level solutions** involving all departments affected. Blaming individuals or shifting workload does not fix the underlying process failure.
A unit’s monthly audit shows a rise in catheter-associated urinary tract infections (CAUTIs). What is the nurse manager’s best action to address this trend?
- Remind staff to “be more careful”
- Review adherence to catheter care protocols and reinforcement needs
- Remove all catheters from the unit
- Ignore the trend until another month of data is available
Explanation: Answer reason: Rising CAUTI rates signal a **quality indicator problem**. The appropriate response is to evaluate whether evidence-based catheter care practices are being followed and reinforce or retrain as necessary.
A nurse discovers that a client received the wrong dose of a high-risk medication, but the client shows no symptoms. What is the nurse’s priority action from a risk-management perspective?
- Wait to see if the client develops symptoms
- Document the mistake in the medical record as a “medication error”
- Only tell the provider so the issue stays private
- Report the error through the facility’s safety reporting system immediately
Explanation: Answer reason: Risk management requires reporting **all medication errors**, even those without harm. Incident reports help identify system weaknesses. The medical record should not contain judgmental labels like “error.”
A unit begins implementing an evidence-based protocol for preventing postoperative pneumonia. After two weeks, several nurses are using older routines instead of the protocol steps. What is the nurse manager’s best action?
- Punish staff who are not following the new protocol
- Review the evidence-based steps with staff and clarify how to integrate them into workflow
- Abandon the protocol because change is too difficult
- Allow each nurse to choose whichever method they prefer
Explanation: Answer reason: Noncompliance often comes from unclear expectations or workflow barriers. Reinforcement, clarification, and support—not punishment—promote consistent use of best practices.
A patient-flow issue is causing delays in transferring clients from the emergency department to the medical-surgical unit. Which action by the nurse manager best demonstrates effective interdisciplinary collaboration?
- Asking the ED nurses to “just work faster”
- Ignoring the delays unless patients complain
- Reassigning an individual nurse who seems slow
- Meeting jointly with ED, transport, and med-surg teams to map the current process and identify bottlenecks
Explanation: Answer reason: Performance Improvement relies on **cross-department teamwork**, shared analysis, and redesigning processes together. Blaming individuals or demanding speed does not fix systemic inefficiencies.
A nurse manager notices that several new staff members are making repeated documentation errors on the electronic health record. What is the most appropriate Performance Improvement response?
- Discipline each nurse individually
- Schedule targeted retraining sessions focused on documentation competency
- Remove the documentation system and return to paper charts
- Ignore the issue unless harm occurs
Explanation: Answer reason: Repeated errors across multiple staff members indicate a **competency gap**, not individual negligence. Targeted education and skill reinforcement are appropriate first steps.
A unit’s falls over the past six months have remained stable at 1–2 per month, but the most recent month shows five falls. What is the nurse manager’s best action?
- Assume it is random variation and take no action
- Review the circumstances of the recent falls and compare them with prior data to identify patterns
- Replace all staff members on that shift
- Remove all walkers and assistive devices to prevent misuse
Explanation: Answer reason: A sudden spike signals a **trend change** that requires investigating contributing factors such as staffing levels, environmental issues, or protocol lapses.
During a safety audit, the manager notices that medication reconciliation is inconsistently completed at discharge. What is the most effective Performance Improvement intervention?
- Tell nurses to “make sure you remember next time”
- Implement a standardized discharge checklist that includes medication reconciliation
- Allow each nurse to use their own preferred discharge method
- Perform medication reconciliation only for high-risk patients
Explanation: Answer reason: Standardizing high-risk steps like med reconciliation reduces omissions and improves reliability. Checklists strengthen consistency and support safer transitions of care.
A unit discovers that their postoperative infection rate is higher than the national benchmark for similar units. What should the nurse manager do first to address this performance gap?
- Inform staff that penalties will occur until rates improve
- Compare current infection-control practices with evidence-based standards to identify deviations
- Assume patient populations are different and ignore the benchmark
- Immediately double all antibiotic doses to reduce infection risk
Explanation: Answer reason: Benchmarking identifies performance gaps. The correct first step is to compare current practices with best-practice standards to pinpoint where care is falling short. Punishment or assumptions do not improve quality.
Nurses report frequent delays in obtaining IV pumps because equipment is stored in multiple locations. Which action best reflects a workflow-redesign approach?
- Tell nurses to request pumps earlier in their shift
- Centralize pump storage in one designated area and track usage patterns
- Assign one nurse to personally search for pumps each shift
- Order double the number of pumps without assessing current processes
Explanation: Answer reason: Workflow redesign aims to reduce inefficiencies by reorganizing processes. Centralizing equipment and monitoring utilization directly addresses the root cause of delays.
A performance review shows that tasks frequently delegated to nursing assistants are not being completed on time, leading to late vital signs and delays in morning care. What is the nurse manager’s most appropriate PI response?
- Conclude that the assistants are not motivated and need punishment
- Evaluate whether assignments are appropriate, realistic, and clearly communicated
- Require assistants to stay overtime until all tasks are completed
- Remove delegation responsibilities from all nurses
Explanation: Answer reason: Delegation problems often reflect **workload imbalance, unclear expectations, or inappropriate task selection**, not staff laziness. PI focuses on system fixes, not blame.
A nurse notices that two different providers ordered conflicting fluid rates for the same client, and neither order references the other. What is the nurse’s best Performance Improvement–aligned action?
- Choose the rate that seems safest and continue care
- Notify the charge nurse and provider to clarify the discrepancy before administering
- Assume the most recent order is correct and proceed
- Document the conflict but wait until rounds to address it
Explanation: Answer reason: Conflicting orders represent a **communication breakdown**, a common source of medical errors. Clarification is required before continuing care—not assumptions or delayed action.
During shift handoff, the outgoing nurse forgets to mention that a client had a blood pressure medication held due to low readings. The incoming nurse administers the dose, and the client becomes hypotensive. Which PI-related action should occur?
- Remind staff to “pay more attention” during handoff
- Review and reinforce structured handoff tools such as SBAR
- Tell nurses to shorten handoffs to reduce confusion
- Assign the nurse who forgot as responsible for the event
Explanation: Answer reason: Handoff errors often occur when information is missing or unstructured. Reinforcing standardized formats (e.g., SBAR) improves consistency and reduces omissions. Blame alone does not improve future performance.
A unit implements a safety protocol requiring nurses to perform a double-check on high-risk medications. A follow-up audit shows inconsistent compliance. What is the nurse manager’s best next step?
- Assume nurses are deliberately ignoring the rule
- Meet with staff to understand workflow barriers and develop strategies to improve adherence
- Remove the protocol since it is not being followed consistently
- Assign one nurse to perform all double-checks for the unit
Explanation: Answer reason: When compliance drops, PI requires **investigating barriers**, not assuming staff negligence. Solutions may involve staffing, time constraints, or unclear expectations.
A unit implemented a new fall-risk screening tool one month ago. The nurse manager now wants to evaluate whether the intervention actually made a difference. What is the most appropriate first step?
- Ask staff whether they “feel” the unit has fewer falls
- Compare fall rates from before and after the tool was implemented
- Survey patients about their satisfaction with room layout
- Assume improvement unless a serious fall occurs
Explanation: Answer reason: To judge intervention effectiveness, PI requires **objective outcome comparison**—pre-intervention vs post-intervention data. Staff feelings or assumptions are not reliable indicators of improvement.
A chart audit shows that nurses are inconsistently documenting pain reassessments after administering analgesics. The manager decides corrective action is needed. What is the most appropriate step?
- Issue written warnings to all staff involved
- Provide focused education and clarify expectations for timely reassessment
- Remove pain reassessment from the documentation workflow
- Only address the issue if a patient complains
Explanation: Answer reason: Corrective action plans target **the process**, not punishment. Education, expectation clarification, and workflow support are the first-line responses to documentation gaps.
A hospital introduced a standardized bedside handoff to improve safety. One month later, the manager reviews outcome data. Which finding best indicates the intervention is achieving its goal?
- Nurses say bedside handoff “takes a bit longer”
- Patients report feeling more included in their care discussions
- Staff mention they prefer the old handoff method
- The number of incident reports remains unchanged
Explanation: Answer reason: Bedside handoff aims to increase patient engagement, accuracy, and transparency. Improved patient involvement is an expected positive outcome and indicates effectiveness.
A unit successfully reduced medication scanning errors after introducing a new barcode system. Three months later, error rates begin creeping back up. What is the nurse manager’s best Performance Improvement action?
- Assume staff are becoming careless again
- Meet with staff to identify barriers and reinforce the original process changes
- Remove the barcode system since it no longer works
- Discipline nurses who make repeated scanning mistakes
Explanation: Answer reason: PI changes require **ongoing reinforcement**. When performance slips, managers review barriers, retrain, and stabilize the improved process—not blame staff or abandon the intervention.
A nurse forgets to complete a fall-risk reassessment on one patient. A review shows that several nurses on the unit have had similar lapses. What does this pattern suggest?
- Individual incompetence
- A system-level issue that needs workflow evaluation
- A need for immediate disciplinary action for all involved
- That fall-risk screening is unnecessary
Explanation: Answer reason: When **multiple staff** repeat the same omission, the problem is usually **systemic**, such as poor workflow, unclear expectations, or documentation design—not individual negligence.
After a new safety checklist is implemented, early audits show excellent compliance. Six weeks later, the manager audits again and finds large variation between shifts. What is the most appropriate PI response?
- Remove the checklist because staff are inconsistent
- Provide targeted feedback to the shifts with lower adherence and review workflow challenges
- Assume compliance will improve on its own
- Punish the shifts with low adherence to motivate improvement
Explanation: Answer reason: Compliance often drifts over time. PI requires **follow-up auditing, targeted coaching, and barrier assessment**, not punishment or abandonment of the tool.
A unit launches a new call-light response protocol. One month later, the manager reviews patient satisfaction surveys and notices more positive comments about “staff responsiveness.” What does this indicate from a Performance Improvement perspective?
- The survey results are subjective and not useful
- The PI intervention may be improving patient-perceived responsiveness
- Staff should shorten all interactions to maintain speed
- The protocol should be discontinued since surveys are not data
Explanation: Answer reason: Patient satisfaction is a legitimate **quality metric**. A positive trend suggests the intervention is influencing patient experience—an intended PI outcome.
After rolling out a new bedside safety check, several nurses give feedback that certain steps are unclear. What is the manager’s best action to close the feedback loop?
- Tell nurses the process must be followed regardless of confusion
- Review the concerns with the team and clarify or adjust the checklist as needed
- Disregard the feedback unless a safety event occurs
- Assign one nurse to rewrite the checklist alone
Explanation: Answer reason: Closing the loop means staff input is **reviewed, addressed, and integrated**. Clarifying unclear steps or refining the checklist strengthens adherence and safety.
A hospital wants to test a new discharge form to reduce readmission errors. Which approach aligns best with PI principles?
- Implement the new form on all units immediately
- Ask staff to choose whichever form they prefer
- Delay testing until the next fiscal year
- Pilot the form on one small unit before deciding on wider rollout
Explanation: Answer reason: PI emphasizes **small tests of change** (pilot testing) before full implementation. This allows evaluation, adjustment, and controlled risk.
A time–motion study on a medical-surgical unit shows that nurses spend a significant portion of each shift walking back and forth to a supply room located at the end of the hallway. What is the most appropriate PI interpretation of these findings?
- Nurses should walk faster to reduce wasted time
- Supplies should be relocated or decentralized to reduce unnecessary travel
- The study is not useful because walking is part of nursing
- Assign one nurse to retrieve all supplies for the unit
Explanation: Answer reason: Time–motion studies help identify **inefficient workflow patterns**. Excessive travel distance signals a modifiable system issue, not staff performance.
A unit is working on a fall-prevention PI project. The manager documents, “Reviewed fall data, educated staff on high-risk patients, implemented hourly rounding, will recheck fall rates in 30 days.” Why is this documentation appropriate?
- It provides a detailed narrative of staff emotions
- It captures the PI steps taken and outlines measurable follow-up
- PI projects do not require written records
- It focuses on individual staff mistakes
Explanation: Answer reason: PI documentation must show **actions taken, interventions implemented, and planned evaluation**. This description reflects a clear improvement cycle, not blame or emotion.
A Performance Improvement review shows that inconsistent medication reconciliation during admission is contributing to duplicate medication orders. Which response best links PI findings to policy development?
- Tell nurses to “remember better” during busy shifts
- Leave the process unchanged until more errors occur
- Develop or revise a standardized admission medication reconciliation policy
- Ask each nurse to create their own personal workflow for reconciliation
Explanation: Answer reason: When PI uncovers a system weakness, policy development or revision is necessary to **standardize safe practice** and prevent recurrence.
A unit introduced a new bedside supply cart to reduce time spent gathering materials. Two weeks later, the manager wants to evaluate whether the intervention improved efficiency. What is the most appropriate measure?
- Ask nurses if the cart “feels more convenient”
- Count how many times the cart was used each shift
- Compare time spent retrieving supplies before and after implementing the cart
- Observe whether staff appear to be moving less in the hallway
Explanation: Answer reason: Efficiency gains must be measured with **objective before–after time data**, not perceptions or assumptions.
Medication deliveries to the surgical floor are frequently delayed because pharmacy technicians must wait for transport staff to become available. What should the nurse manager do from a PI perspective?
- Ask nurses to pick up medications themselves
- Increase the frequency of reminder messages to transport staff
- Report transport staff for poor performance
- Bring pharmacy, nursing, and transport together to map the process and identify shared solutions
Explanation: Answer reason: When delays arise from **cross-department workflow dependencies**, PI requires **interdepartmental coordination**, not blame or isolated fixes.
Staff report that a new patient-identification scanner sometimes fails to read armbands, causing delays. The manager collects examples of when the issue occurs and identifies common patterns. How is this feedback best characterized within PI?
- Staff feedback serving as actionable data to guide system improvement
- Complaints that should not influence PI decisions
- Evidence that scanning should be discontinued
- Proof that staff need more discipline to follow protocols
Explanation: Answer reason: Staff feedback is **PI data**. Patterns reported by frontline workers help identify system failures and guide targeted solutions.
Nurses report that completing morning assessments takes significantly longer on certain days. A quiet observational study shows that supply carts are often empty at the start of the shift. What does this finding represent from a PI perspective?
- Individual nurses failing to organize their time
- An unavoidable delay related to patient acuity
- A problem that should be ignored unless a complaint is filed
- A hidden workflow barrier that must be addressed to improve efficiency
Explanation: Answer reason: Empty supply carts create an unexpected obstacle that disrupts workflow; this is a **hidden system barrier**, not a staff performance problem.
A new double-check process for high-alert medications was implemented. After one week, 100% of required double checks were documented. What should the manager do next to evaluate reliability?
- Continue monitoring compliance over a longer period to ensure the process remains consistent
- Conclude the process is fully reliable and stop auditing
- Replace the double-check process with verbal confirmation only
- Assume staff will maintain compliance automatically
Explanation: Answer reason: Early perfect numbers can be misleading. Reliability is shown when adherence is **sustained over time**.
A unit’s PI review reveals inconsistent wound-care documentation among new staff. What is the most appropriate response?
- Punish staff members who document incorrectly
- Ignore the issue unless patient harm occurs
- Incorporate the PI findings into targeted onboarding and skill training
- Remove wound care documentation requirements
Explanation: Answer reason: When inconsistencies arise, PI findings should guide **focused training and onboarding improvements**, not punishment or omission of requirements.
Monthly audits show that hand hygiene compliance on a unit increased from 78% to 92% after a reminder campaign. What is the manager’s best PI action now?
- Continue periodic audits to ensure the improvement is sustained over time
- End auditing because the goal has been met
- Replace the reminder campaign with a new intervention
- Assume compliance will remain high without follow-up
Explanation: Answer reason: Improvement is meaningful only if it is **maintained**. Continued monitoring ensures gains are sustained and helps detect early decline.
A unit reports that nighttime medication administration errors increase during periods of loud hallway noise from equipment and staff conversations. What should the PI team consider first?
- Retraining nurses on medication safety principles
- Shortening night shift assignments
- Removing equipment from hallways entirely
- Evaluating environmental factors, such as noise levels, that may be contributing to errors
Explanation: Answer reason: Environmental conditions like lighting and noise can directly affect concentration and accuracy. PI must identify and address **contextual contributors**, not assume individual failure.
Staff hesitate to report near-miss events because they fear being blamed. Which PI-focused intervention would best promote a stronger safety culture?
- Increasing disciplinary actions for repeated errors
- Reinforcing just culture principles and encouraging open, blame-free reporting
- Allowing only managers to report incidents
- Conducting anonymous reports without any follow-up analysis
Explanation: Answer reason: A strong safety culture depends on **transparent, non-punitive reporting**. Just culture frameworks support learning from errors instead of assigning blame.
A unit’s PI dashboard shows that the rate of missed medication scans dropped steadily for three months but then sharply increased in the most recent week. What should the manager do first?
- Ignore the increase until next month’s data is available
- Assume individual nurses became careless
- Replace the entire scanning system immediately
- Review the recent workflow or system changes that may have contributed to the sudden rise
Explanation: Answer reason: Visual dashboards help identify **pattern shifts**. A sudden spike signals a system change or barrier that must be investigated—not ignored or blamed on individuals.
A recurring delay in obtaining critical lab results persists despite multiple PI attempts at the unit level. Nurses report that the issue originates from inconsistent processing times in the lab department. What is the manager’s best PI action?
- Escalate the concern to organizational leadership for cross-department review
- Ask nurses to call the lab more frequently for updates
- Assign one nurse exclusively to manage all lab-related tasks
- Advise staff to work around the delay as best as they can
Explanation: Answer reason: When a PI issue spans **multiple departments** and cannot be resolved locally, it must be escalated to higher leadership for system-level coordination.
A unit implemented short, structured start-of-shift huddles to improve situational awareness. After one month, nurses still report confusion about daily priorities. What should the manager do next?
- Discontinue huddles because staff are not benefiting
- Lengthen the huddle to 20 minutes to allow more discussion
- Observe the huddle process to evaluate whether the format is being followed consistently
- Allow each shift to run the huddle however they prefer
Explanation: Answer reason: Before modifying or abandoning an intervention, PI requires observing its **actual implementation**. Many failures occur because the tool isn't being used as intended.
A unit notice shows that medication reconciliation accuracy is consistently higher on day shift compared to night shift. What is the manager’s best PI interpretation?
- Night shift nurses are less motivated
- Workflow or staffing differences between shifts may be influencing performance
- The day shift should handle all reconciliation tasks
- The discrepancy is irrelevant unless an error causes harm
Explanation: Answer reason: When performance differs by shift or unit, PI focuses on identifying **process differences**, not blaming individuals. Staffing levels, timing, or workflow patterns may explain the variation.
A fall-prevention audit reveals that many new hires are missing key steps in the protocol. What should the manager do first?
- Discipline staff who miss steps
- Remove complex steps from the protocol
- Wait to see if performance improves over time
- Provide focused training or mentoring to address the competency gaps
Explanation: Answer reason: When errors cluster among new staff, this signals a **training or competency gap**. The PI response is targeted education, not punishment or waiting.
A unit implements SBAR handoff training. One month later, staff report that handoffs feel clearer and more organized. What should the manager do to evaluate the impact of this change?
- Observe several handoffs to assess whether SBAR is being used as intended
- Ask staff to complete a written test about SBAR components
- Assume the training was successful and move on to another project
- Remove SBAR for shifts that feel it “takes too long”
Explanation: Answer reason: Direct observation confirms whether SBAR is actually being applied and where breakdowns occur. Staff perceptions alone are not enough for PI evaluation.
A sepsis early-recognition protocol was implemented on a medical-surgical unit. Two months later, chart audits show that nurses consistently complete the screening tool, but the number of delayed sepsis treatments has not decreased. What is the manager’s best Performance Improvement action?
- Review the workflow to identify where treatment delays are occurring after screening is completed
- Blame staff for not following the protocol correctly
- Remove the protocol and return to the previous system
- Assume the protocol needs more time to show results
Explanation: Answer reason: If screening compliance is high but outcomes have not improved, the issue likely occurs **after** the screening step. PI requires examining the workflow to find where delays or breakdowns are happening.
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