What can artefact analysis tell us about patient transitions between the hospital and primary care? Lessons from the HANDOVER project

Julie K. Johnson, Vineet M. Arora, Paul R. Barach*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Hospital discharge often faces breakdowns in information, communication, and coordination. The European Union FP7 Health Research Programme commissioned the European HANDOVER Project in 2008, a three year, 3.5 million Euro programme to examine transitions of patient care from the hospital to the community care settings. Six European countries-Italy, the Netherlands, Poland, United Kingdom, Spain, and Sweden-participated in this collaborative study. Objectives: This paper highlights a multi-centre, multi-national research programme. We describe how HANDOVER participants conducted an 'artefact analysis' as one element of the mixed methods study to inform opportunities to make patient handovers between hospital and community care more effective. Methods: The artefact analysis consisted of a four-step process to assess different toolSused in communication and treatment and their effects on the communication processes between the hospital and general practice settings. Results: Four themes emerged from our analysis: (a) The inpatient care of a patient is 'hospital centric' whereby the hospital 'pulls' information regarding a patient's family physician (b) There are rich cognitive artefacts that support the patient clinician encounter; c) The use of information technology does not necessarily improve the communication process; and (d) There is a role for the patient, albeit not particularly well-defined or explicit, as a conduit for essential information communication. Conclusion: Cognitive artefact analysis is an innovative method to provide insights into transitions of patient care. It may be most useful to think about interventions at both the individual patient and the system levels that more fully address and overcome the system issues at work.

Original languageEnglish (US)
Pages (from-to)185-193
Number of pages9
JournalEuropean Journal of General Practice
Issue number3
StatePublished - Sep 2013


  • Artefact analysis
  • Cognitive artefacts
  • Handovers
  • Patient safety
  • Transitions of care

ASJC Scopus subject areas

  • Family Practice


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