287 Summary on different aspects of PCC. The interchangeability of concepts, which is seen around the use of PREMs, but also visible in the field of pediatric patient engagement (part 1), demonstrates the novelty of this research field and emphasizes the need for conceptual clarification. This thesis ends with Chapter 9, the general discussion. This chapter includes a reflection on the main findings, clinical implications, methodological considerations, and future perspectives to promote PCC in clinical care and research. Conclusion The importance of patient-centered care is recognized, but its application is still in its infancy. The shift towards patient-centered care is difficult as it requires a shift in thinking and a redefinition of roles and decision-making for patients, parents, clinicians, policy makers and researchers. This thesis contributes to this goal as it provides scientific information and lessons learned for clinicians and tools to empower both patients and clinicians in their new roles. Key messages Part 1: • Pediatric patients are increasingly engaged in health care projects with the aim of improving the quality of care and tailoring care to the patient’s needs. • Lack of uniformity about the definition of pediatric patient engagement and absence of clear information and support hinders engagement. • All Voices Count is a patient engagement game that can help clinicians engaging pediatric patients in various health care projects. Part 2: • Implementing PROMs in pediatric clinical practice is a challenging process and barriers and facilitators can be identified on multiple domains. • The engagement of all stakeholders (i.e., patients, parents and clinicians) is necessary for successful implementation. • The PROMIS pediatric measures are valid alternatives to the well-known legacy instruments and have the potential to reduce the burden of completing PROMs. Part 3: • PREMs are increasingly used in pediatric health care, but more research is needed to use the PREM results in a meaningful way for quality improvement.
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