We had a problem with the clinics not sending their results then sometimes when they did send them they may be old results, so when we as the transfusion committee rewrote the transfusion criteria I included in the procedure that we require "X" testing for "X" products and that to insure that we had that testing performed, that testing would be ordered for each outpatient transfusion, such as if the patient was to receive packed cells we automatically order a H&H, for platelets we order a Platelet count, FFP a PT/PTT, cryo a fibrinogen. We then took the policy to the Medical Executive Council and the hospital Policy and Procedure committee. At both places I pointed out the requirement and they approved the policy and changes without question. So we now have an unwritten written order for the pretransfusion testing that we need.