This study brings to light the importance of embracing more adequate patient satisfaction measures in the Lebanese hospital accreditation standards. Furthermore, the findings reinforce the importance of weighing the patient perspective in the development and implementation of accreditation systems. As accreditation is not the only driver of patient satisfaction, hospitals are encouraged to adopt complementary means of promoting patient satisfaction.

In the fall of 2014, Health Quality Ontario 1 released A Primary Care Performance Measurement Framework for Ontario. Recognizing the large number of recommended measures and the limited availability of data related to those measures, the Steering Committee for the Primary Care Performance Measurement (PCPM) initiative established a prioritization process to select two subsets of high-value performance measures-one at the system level and one at the practice level. This article describes the prioritization process and its results and outlines the initiatives that have been undertaken to date to implement the PCPM framework and to advance primary care performance measurement and reporting in Ontario. Establishing a framework for primary care measurement and prioritizing systemand practice-level measures are essential steps toward system improvement. Our experience suggests that the process of implementing a performance measurement system is inevitably non-linear and incremental. Résumé À l' automne 2014, Qualité des services de santé Ontario 1 publiait le Cadre de mesure du rendement des soins primaires en Ontario. Conscient du nombre important de mesures recommandées et de la disponibilité limitée des données associées à ces mesures, le comité directeur pour la mesure du rendement des soins primaires (MRSP) a mis au point un processus de priorisation afin de sélectionner deux sous-ensembles de mesures de la performance à forte valeur ajoutée-le premier au niveau du système, l' autre au niveau des cabinets. Cet article décrit le processus de priorisation et ses résultats, puis souligne les initiatives qui ont été entreprises à ce jour pour mettre en oeuvre le cadre de MRSP et pour favoriser, en Ontario, la mesure du rendement et la publication de rapports en ce sens. La mise au point d' un cadre de mesure du rendement des soins primaires et la priorisation de telles mesures au niveau du système et des cabinets sont des étapes essentielles pour l' amélioration du système. Notre expérience suggère que le processus de mise en oeuvre d' un système de mesure de la performance est inévitablement non linéaire et incrémentiel.

Background: Improving health system value and efficiency are considered major policy priorities internationally. Ontario has undergone a primary care reform that included introduction of interprofessional teams. The purpose of this study was to investigate the relationship between receiving care from interprofessional versus noninterprofessional primary care teams and ambulatory care sensitive condition (ACSC) hospitalizations and hospital readmissions. Methods: Population-based administrative databases were linked to form data extractions of interest between the years of 2003-2005 and 2015-2017 in Ontario, Canada. The data sources were available through ICES. The study design was a retrospective longitudinal cohort. We used a "difference-in-differences" approach for evaluating changes in ACSC hospitalizations and hospital readmissions before and after the introduction of interprofessional team-based primary care while adjusting for physician group, physician and patient characteristics. Results: As of March 31st, 2017, there were a total of 778 physician groups, of which 465 were blended capitation Family Health Organization (FHOs); 177 FHOs (22.8%) were also interprofessional teams and 288 (37%) were more conventional group practices ("non-interprofessional teams"). In this period, there were a total of 13,480 primary care physicians in Ontario of whom 4848 (36%) were affiliated with FHOs-2311 (17.1%) practicing in interprofessional teams and 2537 (18.8%) practicing in non-interprofessional teams. During that same period, there were 475,611 and 618,363 multi-morbid patients in interprofessional teams and non-interprofessional teams respectively out of a total of 2,920,990 multi-morbid adult patients in Ontario. There was no difference in change over time in ACSC admissions between interprofessional and non-interprofessional teams between the pre-and post intervention periods. There were no statistically significant changes in all cause hospital readmission s between the post-and pre-intervention periods for interprofessional and non-interprofessional teams.