【Objective】 To reduce the occurrence of blood transfusion delay in primary hospitals, so as to optimize the transfusion process to ensure the blood transfusion safety. 【Methods】 Root cause analysis(RCA) was carried out to evaluate blood transfusion process so as to find the root causes which might affect the safety of blood transfusion. 【Results】 The root causes of this transfusion delay included imperfect transfusion regulations, unreasonable blood inventory management, long distance from the blood center, etc. By improving the time point of submitting samples, from high-risk population, for unexpected antibody screening, the links that might cause delay in the blood transfusion were reduced from 5 to 1. After rectification, no delay in blood transfusion ever occurred in the hospital. 【Conclusion】 The application of RCA in blood quality and safety management can improve the risk awareness of blood transfusion safety management, reduce the incidence of blood transfusion delay in primary hospitals.