285 Summary participating, disease & treatment, social environment, feelings, dealing with staff, acceptation, autonomy, disclosure, and chronically ill peers. Based on these themes, a first version of All Voices Count was developed. Subsequently, All Voices Count was evaluated several times with adolescents and further developed based on feedback received. Adolescents were satisfied with All Voice Count as it helps them to give their opinion regarding different topics in health care more easily. Therefore, All Voices Count has the potential to lower the barrier of including the voice of adolescents in decisionmaking in health care, research and policy. Part 2: Patient Reported Outcome Measures Another aspect of PCC are Patient Reported Outcome Measures (PROMs). PROMs are standardized, validated questionnaires that can be used to include patients’ perspective into decision-making in clinical care. The use of PROMs has shown to be effective in enabling PCC as it increases awareness for patients’ problems and concerns, enhances patient satisfaction, and is associated with improved treatment outcomes. To facilitate the use of PROMs in clinical practice, the Emma Children’s Hospital Amsterdam UMC developed the KLIK PROM portal (www.hetklikt.nu). Over the years, the KLIK PROM portal has been implemented in more than 40 hospitals in the Netherlands. The KLIK expertise center for PROMs and PREMs guides the implementation process. However, PROM implementation is a challenging process and successful implementation requires insight into barriers and facilitators that influence implementation outcomes. In addition, the involvement of all stakeholders (i.e., pediatric patients, parents, clinicians) is crucial. Therefore, Chapter 4 focused on clinicians’ experiences with the implementation of PROMs in pediatric clinical practice using the KLIK PROM portal. In general, clinicians (N=148) were satisfied with the use of the KLIK PROM portal. It gives them a valuable tool for systematically monitoring and discussing patients’ functioning. However, several barriers were identified, such as irrelevant and long PROMs, low response rate, and no integration with the electronic health record. Subsequently, the patients’ and parents perspective on the use of the KLIK PROM portal was described in Chapter 5, which showed that patients (N=8 focus groups, N=31 questionnaire) and parents (N=17 focus groups, N=130 questionnaire) were satisfied with the use of PROMs through the KLIK PROM portal. However, some points of improvement were identified; irrelevant and long PROMs, PROMs were not discussed by the clinician, and a suboptimal lay-out of the KLIK PROM portal. In Chapter 6, implementation science was used by the KLIK expert team to get insight into facilitating determinants and barriers in the implementation process, where after implementation strategies were identified. The Consolidated Framework
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