The efficacy of type and screen to reduce unnecessary cross matches for obstetric patients.

A type-and-screen procedure was established whereby obstetric patients with no complications would be tested for ABO, Rh, and unexpected antibody. If the antibody screen was negative, cross matches would not be performed. Type and screen could be converted in 20 minutes to cross match, or type-specific blood would be immediately available. Our initial results with type and screen demonstrated 65.5% utilization but 399 cross matches were done for 17 transfusions (cross match/transfusion ratio of 17.6/1). The protocol was changed so that all nonbleeding patients would be typed and screened. A total of 503 of the next 563 patients (89.3%) were typed and screened; cross matches provided 33 transfusions (cross match/transfusion ratio of 4.9/1). An estimated 964 cross matches were eliminated with cost savings of $14,460 in 3 months. We concluded that the type-and-screen procedure is an effective tool in reducing the cross match/transfusion ratio and in lowering costs in obstetric patients with no compromise in patient care, even in high-risk patients.