• Sunita Saxena, Janice M Nelson, Melanie Osby, Mrugesh Shah, Raymond Kempf, and Ira A Shulman.
• Los Angeles County-University of Southern California Healthcare Network and Keck School of Medicine, Department of Pathology, Room 2900, 1200 N State St, Los Angeles, CA 90033, USA. ssaxena@lacusc.org
• Arch. Pathol. Lab. Med. 2007 Apr 1;131(4):576-81.

ContextA blood bank can provide compatible blood for an elective surgical procedure, provided a blood sample is received by the laboratory with sufficient time to allow pretransfusion testing and acquire enough compatible red blood cell units. With the push for same-day admission surgical procedures, a patient's pretransfusion blood sample is often collected the morning of surgery. However, if blood is needed, compatible units might not be immediately available.ObjectiveTo define and improve the process of completing presurgical/preadmission type and screen testing and verifying the ABO/Rh status of scheduled surgical patients before they receive a transfusion.Study DesignA list of surgical procedures that might necessitate blood transfusion was created. A checklist was used to ensure that the preoperative clinic nurse collects a baseline pretransfusion blood sample for type and screen testing from patients scheduled for a listed procedure. A new pretransfusion specimen was received on the day of surgery, if needed, so that a current specimen would be available for compatibility testing and to verify the accuracy of the patient's ABO/Rh status in case blood was requested.ResultsDuring the 1-year study period, 666 patients qualified for baseline type and screen testing. Cholecystectomy was the most commonly scheduled surgery. In 99% of cases, a baseline type and screen specimen was received in the laboratory at least 1 day before surgery. The interval between the preoperative clinic visit and date of surgery varied from same day (6 patients) to 3 months.ConclusionTimely receipt of a presurgical specimen for type and screen testing and verification of a patient's ABO/Rh status can be ensured when clinical services collaborate and when the hospital blood utilization committee provides oversight to improve compliance.

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