PROJECT SUMMARY Dr. Auger is a pediatric hospitalist whose overarching career goal is to prevent unnecessary hospitalization. Overview of Project: Pediatric readmission is common; yet, clinicians currently do not have a systematic way to predict which patients will return for an unplanned readmission after discharge. The aims of this proposal are to 1) identify markers of discharge medical complexity and examine their association with readmission; 2) develop a readmission risk prediction tool for unplanned readmission at a single children's hospital; 3) validate the readmission risk prediction tool at a second children's hospital. Candidate: Dr. Auger is an Assistant Professor of Pediatrics in the Division of Hospital Medicine at Cincinnati Children's Hospital Medical Center (CCHMC). She has completed two fellowships: a clinical fellowship in hospital medicine and a Robert Wood Johnson Foundation (RWJF) Clinical Scholars program fellowship in health services research. As part of her RWJF fellowship, she also completed a Masters of Health and Healthcare Research. The proposed K08 career development plan builds upon her fellowship training and early career development to address four areas that require additional training to enhance her trajectory toward becoming an independent investigator: Training Goal 1. Increase expertise on advanced statistical principles. Expertise in risk prediction will be an essential skill for predicting readmission risk for children. In addition, understanding hierarchical modeling will be essential for future research that focuses on hospital outcomes. Training Goal 2. Acquire additional training in social determinants of health. Social risks have been shown to influence post-discharge risk. Dr. Auger requires additional training in the measurement of social determinants to ensure use of the best methods to account for such risk factors in risk prediction tools. Training Goal 3. Acquire skills for developing and implementing interventions. Dr. Auger's training to date has not included implementation science or intervention trials. She will need both of these skills to facilitate further development and testing of interventions targeted to the prevention of readmission during a subsequent R award. Training Goal 4. Strengthen academic and professional development skills. Dr. Auger will continue to develop skills needed to be a successful independent investigator through courses on leadership and writing, reviewing manuscripts, participating in “K club”, and presenting at national conferences. Mentoring Relationships: Dr. Samir S. Shah and Dr. Robert S. Kahn and are serving as Dr. Auger's co- primary mentors. Dr. Shah is an expert in pediatric hospitalizations. He currently is the PI on a PCORI-funded hospital to home transitions grant. Dr. Kahn is an expert in the social determinants of health, having previously received R01 level funding for studying disparities in pediatric asthma readmission. Two other co-mentors comp...