Choosing the top articles published in BMJ Quality and Safety is a challenge every year, and 2022 was no exception. We saw ­­­­­­­a high number of submissions, with a broad range of topics and study designs. As ever, our editors and editorial board had some difficult choices to make in selecting the top Research Articles of the year. For a more detailed look at our Top Article selection process that accounts for editorial assessment of novelty, generalisability, importance to clinical practice, and other factors such as performance metrics on articles first published in 2022, click here. Future blog posts will share more on our Top 10 selections. 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 all of our reviewers who give their time and expertise to peer-reviewing submissions: none of this would be possible without you.

-Bryony Dean Franklin & Eric Thomas

• Examining the effect of quality improvement initiatives on decreasing racial disparities in maternal morbidity by C Davidson et al. BMJ Quality & Safety 2022;31:670-678.

• Effectiveness of a multifaceted quality improvement intervention to improve patient outcomes after total hip and knee arthroplasty: a registry nested cluster randomised controlled trial by P van Schie et al. BMJ Quality & Safety 2023;32:34-46.

• Diagnostic error experiences of patients and families with limited English-language health literacy or disadvantaged socioeconomic position in a cross-sectional US population-based survey by SK Bell et al. Published Online First: 4 February 2022

• Influence of drug safety advisories on drug utilisation: an international interrupted time series and meta-analysis by RL Morrow et al. BMJ Quality & Safety 2022;31:179-190.

• Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme by L Rotteau et al. BMJ Quality & Safety 2022;31:867-877.

• Comparing antibiotic prescribing between clinicians in UK primary care: an analysis in a cohort study of eight different measures of antibiotic prescribing by T Van Staa et al. BMJ Quality & Safety 2022;31:831-838.

• Effects of tall man lettering on the visual behaviour of critical care nurses while identifying syringe drug labels: a randomised in situ simulation by Q Lohmeyer et al. BMJ Quality & Safety 2023;32:26-33.

• Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO): a pragmatic cluster randomised controlled trial evaluating the effectiveness of a facilitation intervention on recognition and response to clinical deterioration by ­TK Bucknall (@nursedecisions) et al. BMJ Quality & Safety 2022;31:818-830.

• Medication-related interventions to improve medication safety and patient outcomes on transition from adult intensive care settings: a systematic review and meta-analysis by RS Bourne et al. BMJ Quality & Safety 2022;31:609-622.

• Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care by S Wieringa et al. Published Online First: 8 March 2022

• How do hospital inpatients conceptualise patient safety? A qualitative interview study using constructivist grounded theory by E Barrow et al. Published online: 5 October 2022

• Documenting the indication for antimicrobial prescribing: a scoping review by S Saini et al. BMJ Quality & Safety 2022;31:787-799.

• Experience of hospital-initiated medication changes in older people with multimorbidity: a multicentre mixed-methods study embedded in the OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM) trial by S Thevelin et al. BMJ Quality & Safety 2022;31:888-898.

• Communication about sexual orientation and gender between clinicians, LGBT+ people facing serious illness and their significant others: a qualitative interview study of experiences, preferences and recommendations by D Braybrook (@DEBraybrook) et BMJ Quality & Safety 2023;32:109-120.

• Impact of unacceptable behaviour between healthcare workers on clinical performance and patient outcomes: a systematic review by L Guo et al. BMJ Quality & Safety 2022;31:679-687.

• Patterns, appropriateness and outcomes of peripherally inserted central catheter use in Brazil: a multicentre study of 12 725 catheters by ER Rabelo-Silva (@eneida_rabelo) et al. BMJ Quality & Safety 2022;31:652-661.

• National improvements in resident physician-reported patient safety after limiting first-year resident physicians’ extended duration work shifts: a pooled analysis of prospective cohort studies by MD Weaver et al. BMJ Quality & Safety 2023;32:81-89.

• Nurse staffing and inpatient mortality in the English National Health Service: a retrospective longitudinal study by B Zaranko (@BenZaranko) et al. Published Online First: 27 September 2022

• Optimising GPs’ communication of advice to facilitate patients’ self-care and prompt follow-up when the diagnosis is uncertain: a realist review of ‘safety-netting’ in primary care by C Friedemann Smith (@cfrieders) et al. BMJ Quality & Safety 2022;31:541-554.

• Implications of resource constraints and high workload on speaking up about threats to patient safety: a qualitative study of surgical teams in Ghana by EK Mawuena et al. BMJ Quality & Safety 2022;31:662-669.

• Impact of the COVID-19 pandemic on the incidence and mortality of hospital-onset bloodstream infection: a cohort study by JK Valik et al. BMJ Quality & Safety 2022;31:379-382.

• Barriers and enablers to monitoring and deprescribing opioid analgesics for chronic non-cancer pain: a systematic review with qualitative evidence synthesis using the Theoretical Domains Framework by AJ Cross (@AmandaJCross) et al. BMJ Quality & Safety 2022;31:387-400.

• Quality framework for remote antenatal care: qualitative study with women, healthcare professionals and system-level stakeholders by L Hinton (@LisaHinton4) et al. Published Online First: 12 May 2022

• Negotiating the polypharmacy paradox: a video-reflexive ethnography study of polypharmacy and its practices in primary care by D Swinglehurst et al. BMJ Quality & Safety 2023;32:150-159.