TypeO4life

Our lab initially used E-XM at time of test results from Result Entry, which was not very different from Immediate Spin XM.
 
We implemented E-XM Dispense via Dispense & Assign Products with other process changes in Feb 2012.  
We see several benefits;  Expired crossmatches are not dispensed.  Fewer overrides occur overall.  The techs are diligent about performing ABO confirmation on a second specimen, so we avoid crossmatching O LRRBCs on non-O patients.  We spend less time on inventory management. We use FIFO more consistently, with the oldest units transfused.  The techs appreciate all the automated checking in this process.  We've reduced mistagged components, with IS XM more than one component for a patient occasionally the tags were transposed. 

We will be going live with electronic crossmatching on April 1st. I've validated it and will begin training staff soon. Crossmatching takes place in Blood Bank Result Entry. You should be able to select Computer Crossmatch (instead of Serological Crossmatch). You barcode in the units like you do for serological crossmatches and then instead of putting in results, if the unit is compatible with the patient it will automatically fill in as Computer XM OK. You'll hit verify and that should be it.

We've been live with Cerner since February 2013 and our process is the same.  We get a unit of the patient's blood type from the fridge, go into Result Entry, scan the sample accession label, scan the barcoded BBID (blood bank i.d. from the armband) on the sample, and then scan the unit (however many are ordered).  As soon as you scan a unit, the computer makes the decision that the unit is ABO compatible with the recipient and automatically fills in the interpretation field with Computer XM OK.  Don' forget to pull a segment from the unit as well as a number sticker--we affix the sticker on a 12X75 tube and place the segment inside folded so it won't fall out.  Often we will wait until a nurse comes to pick up blood and just perform a Computer Crossmatch Dispense at that time.  The only thing is you have to manually enter the BBID in the field in the save dialog box when you are dispensing so that it will print on the donor tag.  Since we do not have the sample in hand at that time, I had to figure out a way to be able to quickly find the blood bank armband i.d.  What I did was to build a BBID result field in the ABORh test so that we can quickly look in Order Result Viewer at the most recent type and screen results and see the BBID.  We can then verify it against the blood request form that the nurse brings which MUST have the BBID on it.  We type this into the BBID field during dispense, pull a segment and sticker and we're done.  We never have to handle the patient's sample again.  It took us awhile to get used to this as we went live with electronic crossmatching the same time we went live with Cerner.  Everyone loves it now and we've never looked back, including this "old timer" blood banker!