When I was born, my parents couldn’t agree on how to spell my name. My dad wanted T-A-N-I-A; my mom insisted on using a “y.” (Check my byline to see which parent eventually won.)
Because my parents didn’t have a name ready for me at my birth, the hospital wrote “Babygirl Basu” on my birth certificate—and I wasn’t alone. Of the 4 million children in 2012 in the U.S., many are assigned the generic “Babygirl” or “Babyboy” when their parents don’t immediately choose a name. Sometimes, parents just aren’t ready to name their children; other times, a newborn is in need of immediate intensive care and there’s no time to enter a name. Still other times, some hospitals have a policy to name children by sex and time of birth as an identifier for the hospital.
A study from Pediatrics suggests that these placeholder names can result in more medical errors, particularly for children born with conditions requiring intensive care.
The researchers—led by Dr. Jason Adelman, patient safety officer at Montefiore Health System in New York and the recent father of an unnamed-at-birth son, who became christened Babyboy Adelman—wanted to test a solution. Between July 1, 2013, and June 30, 2014, they implemented a simple system of assigning temporary names to nameless newborns at Montefiore Medical Center by combining the baby’s mother’s name with their gender. For example, if a newborn baby girl’s mother’s name was Jane, the newborn would be assigned the name Janegirl.
Compared to the hospital’s standard practice in 2013, a year after using the new system, researchers saw a 36.3% reduction in the number of times a newborn received an erroneous patient order.
Not all hospitals follow a standard procedure for naming newborns; some use maternal last names, while others assign a number based on time and order of birth. Others simply use the alphabet. More than 80% of hospitals in a survey of 339 hospitals have fuzzy policies on naming conventions, and many of them resort to simply writing Babyboy or Babygirl on the newborns’ birth certificates. But the problems are magnified when it comes to multiple births, Adelman says: when babies not only share the same last name but also often the same gender and time of birth, along with an elevated risk of complications that may land them in a NICU. Add a long or hyphenated name into the mix—which often gets truncated on hospital paperwork—and the chance of errors increases exponentially, he says.
Naming the baby afterwards doesn’t solve the problem, Adelman points out, since hospital records register names once, and to go back and change these names increases the chance for errors and is expensive. That’s why the effects of this naming system are so significant, he says.
The study was inspired by previous research on adults at Montefiore, where researchers looked at certain types of medical errors—those caused when a doctor would place an order, like a medication, to be delivered to a patient, only to have it returned within a short period of time because it was either the wrong order or the wrong patient. While the national level of all reported hospital errors of this kind was around 10 errors per year, the actual number of errors at Montefiore was around 20 per day. Researchers found these errors through measuring “near-miss errors,” showing that Montefiore wasn’t necessarily making more errors but identifying these near-misses.
Adelman wondered if some of the discrepancy was because of errors made with babies, who wouldn’t be able to report the errors. “You only hear about errors when they’re devastating, near misses,” he says.
Adelman has made it his mission to convince health policymakers of the need to change and standardize hospital policies on child naming. “I think we should do away with these dangerous names,” he says. “We should encourage parents of multiples to have names ready.” And for parents who can’t decide on a name, “hospitals should have a standard policy to use some sort of naming device,” he says.
As for Babyboy Adelman, he has a name now. It’s Charlie.