How do we build a transfusion safety program during challenging times?

BACKGROUND: The SARS-CoV-2 pandemic led to systemic shortages in the blood supply that highlighted the importance of blood stewardship and optimal blood utilization. We built a transfusion safety program in late 2020, the impact of which was immediately apparent. STUDY DESIGN AND METHODS: We describe how we justified and obtained funding and resources to build a transfusion safety program at our institution, how we hired and trained two Transfusion Safety Officers (one registered nurse and one medical laboratory scientist), and highlight three early successful projects: (1) decreasing rejected samples, (2) decreasing blood wastage, and 3. improving processes around ordering Massive Transfusion Protocols (MTPs). RESULTS: Through gap analysis and developing metrics with a goal of providing "early wins," our Transfusion Safety team decreased rejected specimens and blood wastage by approximately 30% each and instituted best practices around MTPs including notification of discontinuation of the protocol to >95%. DISCUSSION: We successfully started a Transfusion Safety Program during a national blood shortage, which immediately impacted our hospital's blood supply through successful projects including blood stewardship. We highlight our program to serve as a practical resource for institutions seeking guidance on how to initiate and sustain a similar program at their institution.