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In general, an MTP policy is set up between ER, OR and the Lab. Here it was the OR and ER physicians who decided what it should include. We started with an MTP partly directed by lab results, but found it unnecessarily cumbersome in practice. For our BB, an MTP includes setting up sets of blood products until the MTP is called off. If you search here with the word "massive" you will see a number of threads that may give you a few ideas. Scott

Yes, you should do at least a small parallel study using the old and the new. Your director will have to decide on how many would be acceptable and define acceptability criteria prior to implementation. I would summarize and have them sign-off before placing it into use.