Naturally, as with most major changes, there was resistance to implementing the practice change. The resistance was answered by providing several educational aids and presentations to help those affected by the change understand the impact on patient safety related to the change. A slide-based presentation describing what was changing, why we were doing this change, to whom the change applied, exceptions to the change, who would pay for the change, who approved this change, and what other institutions have made this change was developed and placed on the Mayo Clinic Transfusion Medicine intranet home page. A link to this presentation was written into various practice change memos and distributed to key stakeholders and practice chairs. The memo briefly outlined the same information as in the presentation and guided readers to use the intranet link to obtain more detailed information. The memo also provided the names of contacts if further questions arose. An institutional newsletter and a Mayo Clinic Department of Laboratory Medicine and Pathology newsletter each ran a feature story in the week just prior to implementation describing the new practice change. Procedures and protocols were updated for phlebotomy and transfusion medicine personnel and both groups were trained prior to the implementation date of November 16, 2010. Midmorning was chosen as the time for implementation because the number of patients seen in the phlebotomy areas at this time is generally lower than at other times during the workday. This allowed for potential problems encountered in the computer programming modifications or the new process without compromising patient schedules.