We require a second specimen from a different draw time if we have no previous history for RBC transfusions, using a computer crossmatch/dispense process. We have 2 exceptions; when there is an autologous donation available, and when the patient is type O. Otherwise, we immed spin crossmatch the autologous unit(s) or type O RBC. Our LIS is set to generate a message to the patients' EMR when we do not have a historical ABO/Rh in our system, which initiates a new blood bank specimen collection by our pre-surgical team. For other transfusion patients we order a non-billed Patient Retype and use a hematology specimen collected at a different time, or send a phlebotomist to collect. Kent Hospital, a Care New England facility, Rhode Island