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There have been a few posts regarding the steps that different institutions take to check a patient's history and how it's documented. At our institution when we receive a specimen there are various identifiers to guide us for our history check. The blood type shows up in bold red on the header. We see antibody/antigen history as a large red AB/AG on the header. Special transfusion requirements are indicated by a large red M. Any other typing discrepancies or serological problems are indicated by a large red C (for freetexted comments). Patient's with previous transfusion reactions have a large red TXRXN. When an associate receives a specimen and sees these mnemonics they are guided to check the "BBK History" section of the LIS where the exact information is outlined. We use Meditech 5.65. Like many other institutions this act is documented in the specimen itself by a result line in the Type and Screen test under History Check - "Previous History" or "No Previous History." When "No Previous History" is entered a free test is reflexed for a Retype (second specimen to verify the patient's blood type). Here's the problem: Using this system as our history check relies on the ability of the registrars to correctly identify the patient and register them as the correct medical record number upon encounter. What is to prevent a registrar from entering a new medical record number for the patient with anti-K & anti-Jk(a)? To continue in this thread, when you do your history check you see No Previous History, reflex your retype, your ABS is either negative or only identifies anti-K and the patient is transfused inappropriately. What does your institution do to prevent a situation such as this? This is something that we're looking at now.