To adjust for any important chance differences between services in baseline patient risk, study personnel blinded to the service will categorize each child as high risk or very high risk based on findings present on admission to a general pediatrics or hospitalist service. This designation will be based on predefined criteria that are easily applied on admission and related to the risk of prolonged or expensive hospitalizations (e.g. transfer from the pediatric ICU, admission to the IMU, mechanical ventilation, with do-not-resuscitate order, or scheduled for surgery).