Improving quality of palliative care requires measurement tools that are valid, reliable and clinically relevant. Donabedian’s model on quality indicators in health care with emphasis on structure, process, and outcome is of particular relevance for palliative care research. To improve services it is necessary to pay attention to all three elements. Structure and process are important for the outcomes they produce, while outcomes can only be changed through the structures and processes that produce them. The key aspect of quality improvement, however, is measuring the outcomes of care. Outcomes can be seen as the result of clinical interventions. They are divided into patient-centred outcomes and organization-centred outcomes. Patientcentred outcomes include patient satisfaction with care, symptom management, functional status, and quality of life. Organisation- centred outcomes focus on quality of care issues as well as on data on mortality and morbidity. The lecture will address first the importance of measurement of outcomes in palliative care research. Second, a brief summary of methodological issues encountered in instrument development and testing in this field will be given. Finally, new innovative approaches to instrument development in palliative care will be discussed, and recommendations will be made as warranted. To exemplify the above, the preliminary results of an ongoing study will be also presented.