We do fetal screens on the Rh negative moms. If positive, our LIS will reflex a KB. We then send to a local reference lab here in town. We usually get a 6 to 8 hour turnaround time which I think is pretty decent. Occasionally, we will get an order for just a KB for trauma cases. We only get one or two a month so it wouldn't be worth the effort to bring them in house. Besides, most techs hate doing them. At my previous employer, we did briefly look into the Tosoh HPLC method but nixed that due to cost. We also looked at sending them to another area hospital that was doing them by flow cytometry. However, they only performed them 3 days a week which wouldn't have helped with STAT TAT requirements. I hope this gives you "food for thought."