Project 'Toward a seamless palliative care trajectory'. This project, funded by ZonMW (Palliantie program), focuses on improving the transition from hospital to primary care in patients with a palliative care need.  We will concentrate on earlier recognition of patients with palliative care needs during hospitalization and discussing patients' preferences and wishes in the last phase of life.  Additionally we  will focus on improvement of handovers to primary care and will propose a blueprint for a transitional palliative care team. Last but not least, we will work on improvement of information handover and support for informal caregivers for patients in the last phase of life.

In the first two years of the project ‘building blocks’ will be created which will be implemented and tested during the next two years in a multicentre stepped-wedge cluster randomised controlled trial.