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The development of IMPACT

IMPACT was created through a collaboration between UMC Utrecht and Erasmus MC with the cooperation of Dutch Centre of Expertise for Children's Palliative Care, children, parents and professionals working in child care and children's hospitals.


The development of IMPACT

Advance Care Planning in Pediatrics

IMPACT is the result of a research project by the Julius Center, UMC Utrecht and the Department of Social Healthcare, Erasmus MC in collaboration with the Dutch Center of Expertise in Children's  Palliative Care. ZonMW financed the project.


The project started in 2016. IMPACT was compiled based on literature research, interview studies with children and parents and a questionnaire survey among paediatricians. IMPACT stands for Implementing Pediatric Advance Care Planning Toolkit. IMPACT consists of 1) information material for young people, parents and professionals, 2) conversation guides for professionals and 3) forms to make a report of an Advance Care Planning conversation.


The two-day training on how to optimally use IMPACT in practice was given for the first time in 2019. Experiences with IMPACT were evaluated through a qualitative interview study in 2019. This study showed that IMPACT is experienced as appropriate and valuable by children, parents and caregivers in the field of pediatric palliative care. At the same time, broad deployment of IMPACT and further implementation require attention. Four follow-up projects will start in 2023. These projects are funded by ZonMW and focus on further development and implementation of IMPACT in practice


IMPACT is currently being evaluated in a scientific study. Experiences of children, parents and professionals are collected and analyzed in a qualitative study. Where necessary, IMPACT will be adjusted based on the results.

Follow-up research started in 2023: Co-IMPACT

In order to make the IMPACT toolkit more widely available in pediatrics and to be further developed immediately, the four-year follow-up study Co-IMPACT started in September 2023. Co-IMPACT must ensure that advance care planning can be used in practice for every child, regardless of his or her diagnosis, stage of illness or socio-cultural background.

Publications about the background, development and evaluation of IMPACT can be found below.

Animation Advance Care Planning

Animation Advance Care Planning