Hospital cited after Intern forgets to include how “cute” baby is in handoff

*warning – satire* David Kessler

During a recent visit by the joint commission at a major academic hospital, auditors reviewed the hospital course of an adorable 6-day old baby boy who was admitted for hyperbilirubinemia and were shocked to find that the intern caring for the baby failed to include the patient’s cuteness level in any of his handoffs.


One auditor anonymously commented:

“This was not solely an issue of information missing from the chart. Even on the paper to-do list exchanged during handoff, you could clearly see next to the patient sticker a little checkbox next to ‘qdaily hematocrit/neonatal bilirubin’ and ‘call patient’s pmd’ but there was a conspicuous absence of cuteness, adorableness, sweetness or any of the JCAHO approved lovability scales.“

All physicians are expected to uphold best practice when it comes to handing over care of their patients. Evidence is mounting that standardized templates can assist with ensuring that no information is lost during transitions in care. Mnemonics such as IPASS or SBAR are fast becoming standard of care at the nation’s best children’s hospitals.  There is even an MOC sponsored by the AAP for ED based handoffs.

When asked about the incident, the brand-new intern sobbed:

“I don’t understand how I missed this. I swear I watched all of those hospital mandate modules- even the one about how to disinfect surgical equipment and how I should leave the hospital any time I feel tired.   Could watching game-of-thrones at the same time really have been that distracting?”

Patient cuteness, or lovability, has long been noted by AHRQ, JCAHO and other organizations to be strongly associated with receiving better care. With so many patients to take care of, it is vital to know how “cute” a patient is in order to inform medical decision-making.

Associate professor and Pediatric ED attending Dr. Hammerbach has made his career investigating the impact of cuteness on prognosis. He tells us:

“If I’m hearing a presentation about a liver transplant patient with fever and tachycardia, and then you tell me the patient is adorable, I will immediately order fluids and pressors on the patient, because the likelihood they will have end-organ dysfunction has just tripled. That is why it is important we train future our future physicians with the proper acumen to discern when a patient is cute vs non-cute. Even the terminology is inconsistent among this new generation. I mean what the heck does ‘tots ador’ mean?? ”

In order for the hospital to reopen, a remediation plan must be in place. The hospital has proposed placing the intern in NICU to ensure all handoffs are supervised by an attending and they will have adequate exposure to a range of cuteness. Of course, this will be supplemented by practice with standardized patients and simulation.

David Kessler

David Kessler

Director of Clinical Simulation and Pediatric Emergency Ultrasound at Columbia University Medical Center
David is also the research director for INSPIRE (International Network for Pediatric Simulation-Based Pediatric Innovation, Research, and Education). Outside of work, he enjoys spending time with his family, tae-kwon-do, saxophone, and musical theater.
David Kessler

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