Barely Significant
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Ontario primary care reform and quality improvement activities: an environmental scan.

BMC Health Serv Res · 2013 · PMC3720221 · PMID 23758856

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a positive trendno p-value reported
Evidence has shown that in a variety of settings, dedicated attempts at achieving the attributes associated with QI have directly resulted in a positive trend in patient care and satisfaction [ 20 ].

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.