Just‐in‐time display of minor red blood cell antibodies

The US healthcare system is responsible for nearly 11 million transfusions per year.1 Standardized pretransfusion testing helps mitigate the risks of this common intervention; however, antibody evanescence and the lack of immunohematology education pose difficulties for clinical teams.2-5 Previously, our institution implemented an EHR “transfusion dashboard” and a “blood tracker” available in each individual patient chart, aiding clinicians in blood product ordering.6, 7 To further these efforts, we have implemented an EHR antibody alert system that organizes current and historical antibody data from our laboratory information system only in 3 different risk stratifications (see Table 1) with corresponding recommendations. The patient is a 39-year-old multiparous female in her second trimester without significant history with an anti-E. See the EHR alert message (Figure 1A). The patient is a 79-year-old female with a history of hypertension and colon cancer with anti-D and anti-C. See the EHR alert message (Figure 1B). The patient is a 27-year-old female with a history of sickle cell disease (HbSS), with many complications with a panagglutinin, anti-Jkb, anti-M, anti-S, anti-Lea, anti-Jsa, anti-C, anti-Cw, and anti-Kell. See the EHR alert message (Figure 1C). We implemented an EHR antibody alert system that has successfully resulted in 850 reserve/hold RBC orders from July 1, 2024, to June 30, 2025, the recommended action of this alert. We thank our multidisciplinary team of physicians, nurses, IT staff, Blood Bank leadership, Quality Improvement Department leadership, Transfusion Safety Officers, and Blood Bank technologists. The authors declare no conflicts of interest. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.