2019 saw an exceptional volume of submissions to BMJ Quality and Safety. The editors and editorial board of the journal had some difficult choices to make about the top articles of the year, taking into account downloads, citations, Altmetrics scores, and other information as well as expert judgement. We thank all authors for their contributions to the journal and congratulate those who appear on the list (in no particular order) below. We are hugely grateful to the reviewers who gave their time and expertise to peer-reviewing submissions: none of this would be possible without you.

–Kaveh Shojania and Mary Dixon-Woods

 

• Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies by VM Vaughn (@ValerieVaughnMD) et al. BMJ Quality & Safety 2019;28:74-84.

 

• Effect of hands-on interprofessional simulation training for local emergencies in Scotland: the THISTLE stepped-wedge design randomised controlled trial by E Lenguerrand (@LenguerrandErik) et al. BMJ Quality & Safety 2020;29:122-134.

 

• Effect on secondary care of providing enhanced support to residential and nursing home residents: a subgroup analysis of a retrospective matched cohort study by T Lloyd (@ThereseTHF) et al. BMJ Quality & Safety 2019;28:534-546.

 

• Effectiveness of double checking to reduce medication administration errors: a systematic review by AK Koyama et al. BMJ Quality & Safety

 

• Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study by P Griffiths (@workforcesoton) et al. BMJ Quality & Safety 2019;28:609-617.

 

• A qualitative positive deviance study to explore exceptionally safe care on medical wards for older people by R Baxter (@RuthMBaxter) et al. BMJ Quality & Safety 2019;28:618-626.

 

• Are more experienced clinicians better able to tolerate uncertainty and manage risks? A vignette study of doctors in three NHS emergency departments in England by R Lawton (@LawtonRebecca) et al. BMJ Quality & Safety 2019;28:382-388.

 

• Sicker patients account for the weekend mortality effect among adult emergency admissions to a large hospital trust by J Sun et al. BMJ Quality & Safety 2019;28:223-230.

 

• Drivers of potentially avoidable emergency admissions in Ireland: an ecological analysis by B Lynch (@bm_lynch) et al. BMJ Quality & Safety 2019;28:438-448.

 

• Effects and costs of implementing predictive risk stratification in primary care: a randomised stepped wedge trial by H Snooks (@hpsnooha) et al. BMJ Quality & Safety 2019;28:697-705.

 

• Electronic health record-based clinical decision support alert for severe sepsis: a randomised evaluation by NL Downing (@ldowningmd) et al. BMJ Quality & Safety 2019;28:762-768.

 

• Evolving quality improvement support strategies to improve Plan–Do–Study–Act cycle fidelity: a retrospective mixed-methods study by C McNicholas (@C_McNic) et al. BMJ Quality & Safety 2019;28:356-365.

 

• Explaining organisational responses to a board-level quality improvement intervention: findings from an evaluation in six providers in the English National Health Service by L Jones (@dr_loreleijones) et al. BMJ Quality & Safety 2019;28:198-204.

 

• Exposure to incivility hinders clinical performance in a simulated operative crisis by D Katz et al. BMJ Quality & Safety 2019;28:750-757.

 

• Low-value care in Australian public hospitals: prevalence and trends over time by T Badgery-Parker et al. BMJ Quality & Safety 2019;28:205-214.

 

• Nursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals by TC Guetterman (@tc_g) et al. BMJ Quality & Safety 2019;28:916-924.

 

• Patients’ perspective on how to improve the care of people with chronic conditions in France: a citizen science study within the ComPaRe e-cohort by V Tran (@thitran3) et al. BMJ Quality & Safety 2019;28:875-886.

 

• Rate of avoidable deaths in a Norwegian hospital trust as judged by retrospective chart review by T Rogne et al. BMJ Quality & Safety 2019;28:49-55.

 

• Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis by WV Padula (@DrWmPadula) et al. BMJ Quality & Safety 2019;28:132-141.

 

• We want to know: patient comfort speaking up about breakdowns in care and patient experience by KA Fisher et al. BMJ Quality & Safety 2019;28:190-197.