PROJECT SUMMARY Pediatric hospitalizations are common and costly in the US, yet there is a scant evidence base to guide care and ensure the best health outcomes for hospitalized children. In the US, there are over 6 million pediatric hospitalizations annually, leading to aggregate costs of nearly $50 billion. The majority of childhood hospitalizations are for common conditions, but currently, there are major gaps in the evidence of how best to care for these conditions (e.g., “what is the most effective systemic corticosteroid regimen for children hospitalized with asthma?”). Additionally, over 70% of US children are hospitalized in community hospitals, but the vast majority of federal funding for pediatric research goes to free-standing children’s hospitals. Evidence gaps and the scarcity of research in community hospital settings contribute to suboptimal health outcomes for hospitalized children, such as complications from unnecessary treatments, prolonged hospital stays, hospital readmissions, and poor chronic disease control. Randomized controlled trials (RCTs) can guide evidence- based care and improve child health outcomes. RCTs minimize potential biases in research findings by randomly allocating study participants to treatment groups. Thus, they represent the highest-quality studies for guiding the care of hospitalized children. Our overall objective is to develop a national RCT agenda in pediatric hospital medicine (PHM) and critical resources for achieving that agenda. To achieve this objective, we propose to hold a research development conference. We have recruited a diverse group of PHM stakeholders for this conference, including multidisciplinary PHM clinicians from children’s and community hospitals (e.g., physicians, nurses, pharmacists), clinical and health services researchers, patients and families, health equity experts, and policymakers. In Aim 1, we will engage conference attendees in using an established method, concept mapping, to identify and prioritize RCT questions for the 20 most prevalent conditions in PHM. In Aim 2, we will identify barriers and facilitators to conducting PHM RCTs in community hospitals. In Aim 3, we will disseminate conference findings via three national partner organizations. Our proposed conference will fill critical gaps by setting an actionable national PHM research agenda, identifying strategies for meaningfully engaging both children’s and community hospitals in achieving this agenda, and assembling critical partners for carrying out this agenda. These findings will have an important positive impact by guiding future research efforts to improve hospital care and health outcomes for children, an AHRQ priority population. Thus, this work aligns with AHRQ’s mission to produce evidence to make health care safer and higher quality.