While choosing the top articles published in BMJ Quality & Safety is a challenge every year, 2020 saw even greater numbers of submissions than in previous years. The editors and editorial board of the journal therefore 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. As well as those involved in this process, we are also hugely grateful to the reviewers who gave their time and expertise to peer-reviewing submissions: none of this would be possible without you.

–Bryony Dean Franklin & Eric Thomas, Editors-in-Chief

• Patient and caregiver priorities in the transition from hospital to home: results from province-wide group concept mapping by T Kiran (@tara_kiran) et al. BMJ Quality & Safety 2020;29:390-400

• Economic analysis of the prevalence and clinical and economic burden of medication error in England by RA Elliott (@RachelElliott67) et al. Published Online First: 11 June 2020

• Use of telecritical care for family visitation to ICU during the COVID-19 pandemic: an interview study and sentiment analysis by F Sasangohar (@Prof_Sasangohar) et al. Published Online First: 07 October 2020

• Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study by KE Raffel (@KatieRaffel) et al. BMJ Quality & Safety 2020;29:971-979

• Incidence, nature and causes of avoidable significant harm in primary care in England: retrospective case note review by AJ Avery (@TonyAvery1) et al. Published Online First: 10 November 2020

• User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study by MD Jones (@MatthewJonesUoB) et al. Published Online First: 30 June 2020

• Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation by EG Liberati (@ElisagLib) et al. Published Online First: 25 September 2020

• What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care by LM Isbell (@lindamisbell) et al. BMJ Quality & Safety 2020;29:1-2

• Work effort, readability and quality of pharmacy transcription of patient directions from electronic prescriptions: a retrospective observational cohort analysis by Y Zheng (@yifancpu) et al. Published Online First: 25 May 2020

• Associations between double-checking and medication administration errors: a direct observational study of paediatric inpatients by JI Westbrook (@JWestbrook91) et al. Published Online First: 07 August 2020

• Identifying and encouraging high-quality healthcare: an analysis of the content and aims of patient letters of compliment by A Gillespie & TW Reader. Published Online First: 08 July 2020

• Association of open communication and the emotional and behavioural impact of medical error on patients and families: state-wide cross-sectional survey by JC Prentice et al. BMJ Quality & Safety 2020;29:883-894

• Assessment of a quality improvement intervention to decrease opioid prescribing in a regional health system by CS Brown (@CraigBrownMD) et al. Published Online First: 16 September 2020

• Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis by AL Neves (@ana_luisa_neves) et al. BMJ Quality & Safety 2020;29:1019-1032

• Costs and consequences of using average demand to plan baseline nurse staffing levels: a computer simulation study by C Saville et al. Published Online First: 26 March 2020

• Impact of multidisciplinary team huddles on patient safety: a systematic review and proposed taxonomy by BJ Franklin (@BrianJFranklin1) et al. BMJ Quality & Safety 2020;29:1-2

• Cluster randomised controlled trial evaluating the clinical and humanistic impact of a pharmacist-led minor ailment service by S Dineen-Griffin (@sarahdgriffin) et al. BMJ Quality & Safety 2020;29:921-931

• ‘Immunising’ physicians against availability bias in diagnostic reasoning: a randomised controlled experiment by S Mamede et al. BMJ Quality & Safety 2020;29:550-559

• How sensitive are avoidable emergency department attendances to primary care quality? Retrospective observational study by B Parkinson (@BethParky24) et al. Published Online First: 03 November 2020

• Validation of automated sepsis surveillance based on the Sepsis-3 clinical criteria against physician record review in a general hospital population: observational study using electronic health records data by JK Valik (@JohnValik) et al. BMJ Quality & Safety 2020;29:735-745