The vein-to-vein transfusion chain consists of two distinct elements - To allow consistent preparation and use of blood components that are safe and clinically efficacious, an appropriate and transparent quality system should be put in place that covers both the management, as well as the technical operations of facilities involved in the chain and leads to the development of a quality culture and sustained stewardship in transfusion medicine. This article describes and discusses the different managerial and operational systems available and their applicability in transfusion medicine; how to master and sustain.