For several years, a tertiary academic medical center received blood products from four blood suppliers to keep up with a demand for red blood cells which was increasing by 5% per year. As a consequence, most of the units were imported from other states and the risk of shortage was high due to the limitations of the process. Realizing the downsides and risks of the situation, the center embarked on a partnership with the American Red Cross with two goals. First, they planned to increase blood collections in the hospital by 200-250%. Second, they decided on a blood management program which started by an audit of their transfusion practices by outside consultants. The steps taken prior, during and after the audit aimed at achieving physician buy-in will be described in this session. Finally, the results of the first two years of the partnership will be shown.