We have several monitors, some directed at utilization review, some directed at patient safety, and some at service. Utilization review: we monitor C/T ratio (good old standby) with a threshhold of 1.5, product wasteage, and appropriateness of transfusion through the transfusion committee. Patient safety: we monitor the specimen rejections for inadequate labeling (patient ID) and the times nursing personnel present to blood bank to pick up product with inadequate patient ID information. We also review the transfusion record for complete documentation. Service: we monitor TAT on uncrossmatched request, TAT on STAT crossmatch from emergency room, and frequency of incomplete orders from our blood supplier. Hopefully you can find something that works for you.