Palliative care from fragmented practise – to a system based upon the best evidence. How can palliative care move from Evidence-Based Medicine to Evidence-Based Practise? From a series of health quality clinical trials, it is shown that systematic evidence based symptom- and function assessment will improve patients’ outcomes – given that this key information is embedded into the clinical decision making processes. We also know, in most countries, this is not happening in routine clinical practise. Barriers at several levels will be addressed: organizational, staff competence, change management, human resistance to change, economic incentives, among others.