We are a small hospital also. We do a retyping on all patients, techs were too confused to be more selective on patients. On our type and screens, I have an automatic default for a confirmation test with a comment attached that a confirmation by ABO/Rh needs to drawn before the patient is transfused. All pre-op patients without a previous ABO/Rh are automatically drawn by our phelebotomist the day of surgery and the nurses now call from ODS to double check to see if we need a confirmation. All in patients, we wait until the next draw unless it is necessary the patient will get transfused, then we will redraw for the confirmation. We do use purple (CBC) or blue (COAG). All outpatients the confirmation is cancelled. In an emergency we follow the protocol for emergency transfusions by giving O neg. We did have reluctance with nurses and doctors at first, not anymore. The policy works very smoothly.