BMJ Quality & Safety

Article	Citations
Economic analysis of the prevalence and clinical and economic burden of medication error in England	153
Chronic hospital nurse understaffing meets COVID-19: an observational study	146
Managing teamwork in the face of pandemic: evidence-based tips	85
Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis	63
SEIPS 101 and seven simple SEIPS tools	62
Use of telecritical care for family visitation to ICU during the COVID-19 pandemic: an interview study and sentiment analysis	60
Prevalence of harmful diagnostic errors in hospitalised adults: a systematic review and meta-analysis	53
Impact of multidisciplinary team huddles on patient safety: a systematic review and proposed taxonomy	51
Impact of COVID-19 restrictions on diabetes health checks and prescribing for people with type 2 diabetes: a UK-wide cohort study involving 618 161 people in primary care	48
Vulnerability of the medical product supply chain: the wake-up call of COVID-19	47
The problem with making Safety-II work in healthcare	36
Overuse of diagnostic testing in healthcare: a systematic review	33
International recommendations for a vascular access minimum dataset: a Delphi consensus-building study	32
Understanding decisions about antibiotic prescribing in ICU: an application of the Necessity Concerns Framework	32
Exploring the actionability of healthcare performance indicators for quality of care: a qualitative analysis of the literature, expert opinion and user experience	31
Associations of workflow disruptions in the operating room with surgical outcomes: a systematic review and narrative synthesis	27
A realist synthesis of quality improvement curricula in undergraduate and postgraduate medical education: what works, for whom, and in what contexts?	27
Incidence, nature and causes of avoidable significant harm in primary care in England: retrospective case note review	27
Advancing health equity in patient safety: a reckoning, challenge and opportunity	27
Cost of contact: redesigning healthcare in the age of COVID	26
Seven features of safety in maternity units: a framework based on multisite ethnography and stakeholder consultation	25
Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study	24
Effects of night surgery on postoperative mortality and morbidity: a multicentre cohort study	24
Effectiveness of a medication adherence management intervention in a community pharmacy setting: a cluster randomised controlled trial	24
Adherence to guideline-recommended HbA1c testing frequency and better outcomes in patients with type 2 diabetes: a 5-year retrospective cohort study in Australian general practice	23

Effectiveness of a multifaceted intervention to improve emergency department care of low back pain: a stepped-wedge, cluster-randomised trial	23
Systematic review and meta-analysis of interventions for operating room to intensive care unit handoffs	23
Antibiotic overuse: managing uncertainty and mitigating against overtreatment	23
Socioeconomic deprivation and ethnicity inequalities in disruption to NHS hospital admissions during the COVID-19 pandemic: a national observational study	22
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	22
Should electronic differential diagnosis support be used early or late in the diagnostic process? A multicentre experimental study of Isabel	22
Trauma Resuscitation Using in situ Simulation Team Training (TRUST) study: latent safety threat evaluation using framework analysis and video review	22
Incidence, origins and avoidable harm of missed opportunities in diagnosis: longitudinal patient record review in 21 English general practices	21
Medication-related interventions delivered both in hospital and following discharge: a systematic review and meta-analysis	21
Assessment of a quality improvement intervention to decrease opioid prescribing in a regional health system	20
Examining the effect of quality improvement initiatives on decreasing racial disparities in maternal morbidity	19
Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study	18
Effect of preoperative education and ICU tour on patient and family satisfaction and anxiety in the intensive care unit after elective cardiac surgery: a randomised controlled trial	18
Complex interplay between moral distress and other risk factors of burnout in ICU professionals: findings from a cross-sectional survey study	17
A realist synthesis of pharmacist-conducted medication reviews in primary care after leaving hospital: what works for whom and why?	17
Effectiveness of chest pain centre accreditation on the management of acute coronary syndrome: a retrospective study using a national database	17
The Irish National Adverse Event Study-2 (INAES-2): longitudinal trends in adverse event rates in the Irish healthcare system	17
To improve quality, leverage design	17
Interventions targeted at reducing diagnostic error: systematic review	17
Associations between double-checking and medication administration errors: a direct observational study of paediatric inpatients	17
Making communication and resolution programmes mission critical in healthcare organisations	16
Improving diagnostic performance through feedback: the Diagnosis Learning Cycle	16
Association between intrahospital transfer and hospital-acquired infection in the elderly: a retrospective case–control study in a UK hospital network	16
Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care	16
Medication-related interventions to improve medication safety and patient outcomes on transition from adult intensive care settings: a systematic review and meta-analysis	16
Visual mapping of team dynamics and communication patterns on surgical ward rounds: an ethnographic study	16
Cutting edge or blunt instrument: how to decide if a stepped wedge design is right for you	16
Concordance with urgent referral guidelines in patients presenting with any of six ‘alarm’ features of possible cancer: a retrospective cohort study using linked primary care records	15
Improving peripherally inserted central catheter appropriateness and reducing device-related complications: a quasiexperimental study in 52 Michigan hospitals	15
Impact of unacceptable behaviour between healthcare workers on clinical performance and patient outcomes: a systematic review	15
Is greater patient involvement associated with higher satisfaction? Experimental evidence from a vignette survey	15
Use of patient complaints to identify diagnosis-related safety concerns: a mixed-method evaluation	15
Bridging the feedback gap: a sociotechnical approach to informing clinicians of patients’ subsequent clinical course and outcomes	15
Diagnostic error in hospitals: finding forests not just the big trees	14
The problem with ‘My Five Moments for Hand Hygiene’	14
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	14
Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study	14
Barriers and enablers to the implementation of multidisciplinary team meetings: a qualitative study using the theoretical domains framework	14
Impact of COVID-19 on opioid use in those awaiting hip and knee arthroplasty: a retrospective cohort study	14
Grand rounds in methodology: when are realist reviews useful, and what does a ‘good’ realist review look like?	14
Patient-level and hospital-level variation and related time trends in COVID-19 case fatality rates during the first pandemic wave in England: multilevel modelling analysis of routine data	14
Sustaining quality improvement efforts: emerging principles and practice	14
Improving the quality of self-management support in ambulatory cancer care: a mixed-method study of organisational and clinician readiness, barriers and enablers for tailoring of implementation strate	14
Improving responses to safety incidents: we need to talk about justice	13
Patient-centred care delivered by general practitioners: a qualitative investigation of the experiences and perceptions of patients and providers	13
Use of e-triggers to identify diagnostic errors in the paediatric ED	13
Time out! Rethinking surgical safety: more than just a checklist	12
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	12
Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations	12
Effects of CPOE-based medication ordering on outcomes: an overview of systematic reviews	12

Identifying and encouraging high-quality healthcare: an analysis of the content and aims of patient letters of compliment	12
COVID-19 hospital prevalence as a risk factor for mortality: an observational study of a multistate cohort of 62 hospitals	12
Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme	12
Looking back on the history of patient safety: an opportunity to reflect and ponder future challenges	12
Timeout procedure in paediatric surgery: effective tool or lip service? A randomised prospective observational study	12
Priorities to improve the care for chronic conditions and multimorbidity: a survey of patients and stakeholders nested within the ComPaRe e-cohort	11
From kamishibai card to key card: a family-targeted quality improvement initiative to reduce paediatric central line-associated bloodstream infections	11
Implementing receiver-driven handoffs to the emergency department to reduce miscommunication	11
Changing hospital organisational culture for improved patient outcomes: developing and implementing the leadership saves lives intervention	11
Achieving patient priorities: an alternative to patient-reported outcome measures (PROMs) for promoting patient-centred care	11
Virtual learning collaboratives to improve urine culturing and antibiotic prescribing in long-term care: controlled before-and-after study	11
Can we safely continue to offer surgical treatments during the COVID-19 pandemic?	11
Using a dark logic model to explore adverse effects in audit and feedback: a qualitative study of gaming in colonoscopy	11
Systematically capturing and acting on insights from front-line staff: the ‘Bedside Learning Coordinator’	11
Determining the skills needed by frontline NHS staff to deliver quality improvement: findings from six case studies	11
Adverse events in the paediatric emergency department: a prospective cohort study	11
Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care	11
User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study	11
Emotional safetyispatient safety	10
Improving surgical quality in low-income and middle-income countries: why do some health facilities perform better than others?	10
Inpatient patient safety events in vulnerable populations: a retrospective cohort study	10
Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the 7-day services national health policy	10
Work effort, readability and quality of pharmacy transcription of patient directions from electronic prescriptions: a retrospective observational cohort analysis	10
Economic evaluations of audit and feedback interventions: a systematic review	10
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 re	10
Primary care physician’s (PCP) perceived value of patient-reported outcomes (PROs) in clinical practice: a mixed methods study	10
Helping healthcare teams to debrief effectively: associations of debriefers’ actions and participants’ reflections during team debriefings	10
Standardised approach to measuring goal-based outcomes among older disabled adults: results from a multisite pilot	10
Sustainability of paediatric asthma care quality in community hospitals after ending a national quality improvement collaborative	9
Accreditation in health care: does it make any difference to patient outcomes?	9
Reaching 95%: decision support tools are the surest way to improve diagnosis now	9
Variation in the design of Do Not Resuscitate orders and other code status options: a multi-institutional qualitative study	9
Patient safety and hospital visiting at the end of life during COVID-19 restrictions in Aotearoa New Zealand: a qualitative study	9
Choice architecture in physician–patient communication: a mixed-methods assessments of physicians’ competency	9
Medical crisis checklists in the emergency department: a simulation-based multi-institutional randomised controlled trial	9
Variation in timely surgery for hip fracture by day and time of presentation: a nationwide prospective cohort study from the National Hip Fracture Database for England, Wales and Northern Ireland	9
mHOMR: the acceptability of an automated mortality prediction model for timely identification of patients for palliative care	9
How do hospital inpatients conceptualise patient safety? A qualitative interview study using constructivist grounded theory	9
The debrief imperative: building teaming competencies and team effectiveness	9
Overdiagnosis of urinary tract infection linked to overdiagnosis of pneumonia: a multihospital cohort study	9
Choosing quality problems wisely: identifying improvements worth developing and sustaining	9
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	8
Influence of bedspacing on outcomes of hospitalised medicine service patients: a retrospective cohort study	8
Comparing antibiotic prescribing between clinicians in UK primary care: an analysis in a cohort study of eight different measures of antibiotic prescribing	8
Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices	8
Impact of trauma centre accreditation on mortality and complications in a Canadian trauma system: an interrupted time series analysis	8
Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review	8
A scoping review of real-time automated clinical deterioration alerts and evidence of impacts on hospitalised patient outcomes	8
Nationwide study on trends in unplanned hospital attendance and deaths during the 7 weeks after the onset of the COVID-19 pandemic in Denmark	8
Crisis checklists in emergency medicine: another step forward for cognitive aids	8
Days alive and at home after hip fracture: a cross-sectional validation of a patient-centred outcome measure using routinely collected data	8
Burden of serious harms from diagnostic error in the USA	8
Roles and effectiveness of knowledge brokers for translating clinical practice guidelines in health-related settings: a systematic review	8
I-PASS handover system: a decade of evidence demands action	8
The effectiveness of interruptive prescribing alerts in ambulatory CPOE to change prescriber behaviour & improve safety	8
Incidence and characteristics of adverse events in paediatric inpatient care: a systematic review and meta-analysis	8
How does the effectiveness of strategies to improve healthcare provider practices in low-income and middle-income countries change after implementation? Secondary analysis of a systematic review	8
Outcomes for surgical procedures funded by the English health service but carried out in public versus independent hospitals: a database study	7
The need for quality self-management support in cancer care	7
Safety cases for digital health innovations: can they work?	7
Fighting a common enemy: a catalyst to close intractable safety gaps	7
Mortality and pulmonary complications in patients undergoing upper extremity surgery at the peak of the SARS-CoV-2 pandemic in the UK: a national cohort study	7
Quality framework for remote antenatal care: qualitative study with women, healthcare professionals and system-level stakeholders	7
Evaluation of the NHS England evidence-based interventions programme: a difference-in-difference analysis	7
Unnecessary antibiotic prescribing in children hospitalised for asthma exacerbation: a retrospective national cohort study	7
Indirect effects of the COVID-19 pandemic on people with type 2 diabetes: time to urgently move into a recovery phase	7
Tiered daily huddles: the power of teamwork in managing large healthcare organisations	7
Devil in the details: understanding the effects of providing electronic health record access to patients and families	7
Association of clinical competence, specialty and physician country of origin with opioid prescribing for chronic pain: a cohort study	7
Systematic review of clinical debriefing tools: attributes and evidence for use	7
Quality of acute myocardial infarction care in England and Wales during the COVID-19 pandemic: linked nationwide cohort study	7
Comparing peripherally inserted central catheter-related practices across hospitals with different insertion models: a multisite qualitative study	7
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 i	7
How sensitive are avoidable emergency department attendances to primary care quality? Retrospective observational study	6
High reliability organising in healthcare: still a long way left to go	6
Types and effects of feedback for emergency ambulance staff: a systematic mixed studies review and meta-analysis	6
Unacceptable behaviours between healthcare workers: just the tip of the patient safety iceberg	6
Influence of drug safety advisories on drug utilisation: an international interrupted time series and meta-analysis	6
Documenting the indication for antimicrobial prescribing: a scoping review	6
Cost-effectiveness of a quality improvement project, including simulation-based training, on reducing door-to-needle times in stroke thrombolysis	6

Conceptualising interventions to enhance spread in complex systems: a multisite comprehensive medication review case study	6
‘My Five Moments’: understanding a user-centred approach to hand hygiene improvement within a broader implementation strategy	6
Epidemiology of adverse drug events and medication errors in four nursing homes in Japan: the Japan Adverse Drug Events (JADE) Study	6
Publication of inspection frameworks: a qualitative study exploring the impact on quality improvement and regulation in three healthcare settings	6
Predictors and population health outcomes of persistent high GP turnover in English general practices: a retrospective observational study	6
Differences in transitional care processes among high-performing and low-performing hospital-SNF pairs: a rapid ethnographic approach	6
Nurse staffing and inpatient mortality in the English National Health Service: a retrospective longitudinal study	5
Mixed-methods study examining family carers’ perceptions of the relationship between intrahospital transitions and patient readiness for discharge	5
Nursing implications of an early warning system implemented to reduce adverse events: a qualitative study	5
Distance travelled to hospital for emergency laparotomy and the effect of travel time on mortality: cohort study	5
Implications of resource constraints and high workload on speaking up about threats to patient safety: a qualitative study of surgical teams in Ghana	5
Effect on diagnostic accuracy of cognitive reasoning tools for the workplace setting: systematic review and meta-analysis	5
Use of optimised dual statistical process control charts for early detection of surgical site infection outbreaks	5
Surgical implementation gap: an interrupted time series analysis with interviews examining the impact of surgical trials on surgical practice in England	5
Work systems analysis of sterile processing: assembly	5
Variation in tonsillectomy cost and revisit rates: analysis of administrative and billing data from US children’s hospitals	5
Effect of the surgical safety checklist on provider and patient outcomes: a systematic review	5
Rethinking standardised infection rates and risk adjustment in the COVID-19 era	5
Mental health services: quality, safety and suicide	5
Choosing Wisely and the climate crisis: a role for clinicians	5
Retrospective evaluation of an intervention based on training sessions to increase the use of control charts in hospitals	5
CODE: a practical framework for advancing patient-centred code status discussions	5
Development and validation of an A3 problem-solving assessment tool and self-instructional package for teachers of quality improvement in healthcare	5
Negotiating the polypharmacy paradox: a video-reflexive ethnography study of polypharmacy and its practices in primary care	5
What works in medication reconciliation: an on-treatment and site analysis of the MARQUIS2 study	5
Retrospective analysis of reported suicide deaths and attempts on veterans health administration campuses and inpatient units	5
Handoff improvement and adverse event reduction programme implementation in paediatric intensive care units in Argentina: a stepped-wedge trial	5
Impact of the COVID-19 pandemic on the incidence and mortality of hospital-onset bloodstream infection: a cohort study	5
Measuring what matters: refining our approach to quality indicators	5
Grand rounds in methodology: four critical decision points in statistical process control evaluations of quality improvement initiatives	5
Examining organisational responses to performance-based financial incentive systems: a case study using NHS staff influenza vaccination rates from 2012/2013 to 2019/2020	4
Continuous quality improvement in statistical code: avoiding errors and improving transparency	4
Polypharmacy and continuity of care: medicines optimisation in the era of multidisciplinary teams	4
Nurse-led triage of new sleep referrals is associated with lower risk of potentially contraindicated sleep testing: a retrospective cohort study	4
Well spotted: but now you need to do something	4
Development and validation of a new ICD-10-based screening colonoscopy overuse measure in a large integrated healthcare system: a retrospective observational study	4
Effects of tall man lettering on the visual behaviour of critical care nurses while identifying syringe drug labels: a randomised in situ simulation	4
Paving the PICC journey: building structures, process and engagement to improve outcomes	4
Consent and refusal of procedures during labour and birth: a survey among 11 418 women in the Netherlands	4
Evaluating patient-reported outcome measures in Peru: a cross-sectional study of satisfaction and net promoter score using the 2016 EnSuSalud survey	4
Improving health equity through clinical innovation	4
Channelling the force of audit and feedback: averting the dark side	4
“It’s not just hacking for the sake of it”: a qualitative study of health innovators’ views on patient-driven open innovations, quality and safety	4
Weekly variation in quality of care for acute ST-segment elevation myocardial infarction by day and time of admission: a retrospective observational study	4
Safe care on maternity units: a multidimensional balancing act	4
Mortality before and after reconfiguration of the Danish hospital-based emergency healthcare system: a nationwide interrupted time series analysis	4
Patterns, appropriateness and outcomes of peripherally inserted central catheter use in Brazil: a multicentre study of 12 725 catheters	4
Effect of contextual factors on the prevalence of diagnostic errors among patients managed by physicians of the same specialty: a single-centre retrospective observational study	4
We don’t talk about communication: why technology alone cannot save clinically deteriorating patients	4
Association between paediatric intraoperative anaesthesia handover and adverse postoperative outcomes	4
Surgical service monitoring and quality control systems at district hospitals in Malawi, Tanzania and Zambia: a mixed-methods study	4
Apology laws and malpractice liability: what have we learned?	4
Sustaining interventions in care homes initiated by quality improvement projects: a qualitative study	4
Effectiveness of a multifaceted quality improvement intervention to improve patient outcomes after total hip and knee arthroplasty: a registry nested cluster randomised controlled trial	4
Quality improvement as a primary approach to change in healthcare: a precarious, self-limiting choice?	4
Less is more, now more than ever	4
Moving beyond the weekend effect: how can we best target interventions to improve patient care?	4
Improving timeliness of hepatitis B vaccine administration in an urban safety net level III NICU	4
Promise and perils of patient decision aids for reducing low-value care	4
Leveraging big data to guide better nurse staffing strategies	3
Evaluating the safety of mental health-related prescribing in UK primary care: a cross-sectional study using the Clinical Practice Research Datalink (CPRD)	3
Competing risks in quality and safety research: a framework to guide choice of analysis and improve reporting	3
Delayed diagnosis of serious paediatric conditions in 13 regional emergency departments	3
Reducing unnecessary diagnostic phlebotomy in intensive care: a prospective quality improvement intervention	3
Challenge of optimising medication in people with severe mental illness	3
Reconfiguring emergency and acute services: time to pause and reflect	3
Beyond the equity project: grounding equity in all quality improvement efforts	3
Diagnostic errors and harms in primary care: insights to action	3
We’re all in this together: how COVID-19 revealed the co-construction of mindful organising and organisational reliability	3
Illness severity characteristics and outcomes of patients remaining on an acute ward following medical emergency team review: a latent profile analysis	3
Addressing social determinants of health in primary care: a quasi-experimental study using unannounced standardised patients to evaluate the impact of audit/feedback on physicians' rates of identifyin	3
Does recruiting patients to diabetes prevention programmes via primary care reinforce existing inequalities in care provision between general practices? A retrospective observational study	3
The cost of improving care: a multisite economic analysis of hospital resource use for implementing recommended postpartum contraception programmes	3
Prioritising Responses Of Nurses To deteriorating patient Observations (PRONTO): a pragmatic cluster randomised controlled trial evaluating the effectiveness of a facilitation intervention on recognit	3
Have we forgotten the moral justification for patient-centred care?	3
CheckPOINT: a simple tool to measure Surgical Safety Checklist implementation fidelity	3
Does removing financial incentives lead to declines in performance? A controlled interrupted time series analysis of Medicare Advantage Star Ratings programme performance	3
Value of a value culture survey for improving healthcare quality	3
To improve quality, keep your eyes on the road	3
Implementation challenges to patient safety in Guatemala: a mixed methods evaluation	3
Accuracy of telephone triage for predicting adverse outcomes in suspected COVID-19: an observational cohort study	3
Addressing long-term and repeat antibiotic prescriptions in primary care: considerations for a behavioural approach	3
Patient-centred outcomes of imaging tests: recommendations for patients, clinicians and researchers	3
Is it time for greater patient involvement to enhance transitional medication safety?	3
Disclosing medical errors: prioritising the needs of patients and families	3
How to co-design a prototype of a clinical practice tool: a framework with practical guidance and a case study	3
Overcoming the ‘self-limiting’ nature of QI: can we improve the quality of patient care while caring for staff?	3
Improving access in a VA primary care clinic using an innovative Panel Retention Tool: a quality improvement report	3
Visual identifiers for people with dementia in hospitals: a qualitative study to unravel mechanisms of action for improving quality of care	3
Addressing disparities in patients’ opportunities for and competencies in shared decision making	3
Research to improve diagnosis: time to study the real world	3