This project uses the ECRS (elimination, combination, rearrangement, and simplification) quality control method to review and improve the blood preparation by sharing specimen in neonatal intensive care unit (NICU). The purpose is to reform and simplify the content and process of blood preparation in NICU, and protect patients' blood safety and maximize the benefits of blood transfusion. The blood specimens were shared between the hematology laboratory for routine examination and the blood bank for blood preparation. If blood preparation is required, the specimen in the hematology laboratory will be retrieved to the NICU, relabeled through a double-check by the collector and the witnesses, and sent to the blood bank for blood preparation. The multiple delivering process is time-consuming, and will delay blood preparation and transfusion. Therefore, how to improve the blood preparation time of the NICU by improving the process is an important issue. In July 2019, the quality control circle was formed by the hematology laboratory, blood bank, NICU and affairs department. After applying the ECRS approach to optimizing the process, the total time of blood preparation in the NICU was reduced from 158.0 minutes to 104.6 minutes, equal to 144.7% target achieving rate. The process was afterwards included in the standard operation procedure.