Inappropriate transfusion practices are common in hospitals, straining Canada’s blood supply and posing risks to patients. Leading guidelines and Choosing Wisely Canada recommendations provide guidance on reducing inappropriate red blood cell (RBC) transfusions. In this article, authors highlight the collaborative and multifaceted approach adopted by Niagara Health hospitals to optimize RBC transfusion utilization and align with national appropriateness benchmarks in the Using Blood Wisely program.