Choosing the top articles published in BMJ Quality and Safety is always both a joy and a challenge, and 2023 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 assessment of novelty, generalizability, importance to clinical practice, and other factors such as performance metrics, click here. Future blog posts will share more details on each of 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

• Patient safety in remote primary care encounters: multimethod qualitative study combining Safety I and Safety II analysis by R Payne et al. BMJ Quality & Safety Published Online First: 28 November 2023

• A realist review of medication optimisation of community dwelling service users with serious mental illness by J Howe (@DrJoHowe) et al. BMJ Quality & Safety Published Online First: 07 December 2023

• Why is safety in intrapartum electronic fetal monitoring so hard? A qualitative study combining human factors/ergonomics and social science analysis by G Lamé et al. BMJ Quality & Safety Published Online First: 09 November 2023

• Indication documentation and indication-based prescribing within electronic prescribing systems: a systematic review and narrative synthesis by C Feather (@calandrafeather) et al. BMJ Quality & Safety 2023;32:357-368

• Health services under pressure: a scoping review and development of a taxonomy of adaptive strategies by B Page (@bethanpage21) et al. BMJ Quality & Safety Published Online First: 29 November 2023

• What can Safety Cases offer for patient safety? A multisite case study by EG Liberati et al. BMJ Quality & Safety 2024;33:156-165

• Initial opioid prescription characteristics and risk of opioid misuse, poisoning and dependence: retrospective cohort study by A García-Sempere et al. BMJ Quality & Safety .

• Quality and reporting of large-scale improvement programmes: a review of maternity initiatives in the English NHS, 2010-2023 by J McGowan (@jgmcgowan) et al. BMJ Quality & Safety Published Online First: 29 November 2023

• Factors that influence the implementation of (inter)nationally endorsed health and social care standards: a systematic review and meta-summary by Y Kelly et al. BMJ Quality & Safety 2023;32:750-762

• Patient safety and hospital visiting at the end of life during COVID-19 restrictions in Aotearoa New Zealand: a qualitative study by A Collier et al. BMJ Quality & Safety 2023;32:704-711

• “It’s probably an STI because you’re gay”: a qualitative study of diagnostic error experiences in sexual and gender minority individuals by AA Wiegand et al. BMJ Quality & Safety Published Online First: 10 May 2023

• CheckPOINT: a simple tool to measure Surgical Safety Checklist implementation fidelity by R Moyal-Smith et al. BMJ Quality & Safety Published Online First: 21 September 2023

• Burden of serious harms from diagnostic error in the USA by DE Newman-Toker (@DNewmanToker) et al. BMJ Quality & Safety 2024;33:109-120

• Consent and refusal of procedures during labour and birth: a survey among 11 418 women in the Netherlands by MSG van der Pijl (@maritvanderpijl) et al. BMJ Quality & Safety Published Online First: 22 May 2023

• Types and effects of feedback for emergency ambulance staff: a systematic mixed studies review and meta-analysis by C Wilson (@999_Caitlin) et al. BMJ Quality & Safety 2023;

• Did the Acute Frailty Network improve outcomes for older people living with frailty? A staggered difference-in-difference panel event study by A Street et al. BMJ Quality & Safety 2023;32:721-731

• How to co-design a prototype of a clinical practice tool: a framework with practical guidance and a case study by M Woodward et al. BMJ Quality & Safety Published Online First: 12 December 2023

• Equitable and accessible informed healthcare consent process for people with intellectual disability: a systematic literature review by M Dunn et al. BMJ Quality & Safety Published Online First: 09 December 2023

• Systematic review of clinical debriefing tools: attributes and evidence for use by EC Phillips et al. BMJ Quality & Safety

• What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study by JL Schnipper (@drjschnip) et al. BMJ Quality & Safety 2023;32:457-469

• Association between language discordance and unplanned hospital readmissions or emergency department revisits: a systematic review and meta-analysis by JN Chu (@janetnchu) et al. BMJ Quality & Safety Published Online First: 30 December 2023

• Predictors and population health outcomes of persistent high GP turnover in English general practices: a retrospective observational study by R Parisi (@RosaParisi09) et al. BMJ Quality & Safety 2023;32:394-403

• Development and validation of the Overall Fidelity Enactment Scale for Complex Interventions (OFES-CI) by L Ginsburg et al. BMJ Quality & Safety 2024;33:98-108