Due to financial constraints and economies of scale many hospitals are merging. Changes in executive leadership and staff can transform the strategic plan. While a merger is of equals, often their patient blood management (PBM) programs are not. Each may carry its own strengths and weaknesses. It is important that the PBM program continue to play a prominent role in the healthcare system culture post-merger. This session will discuss how two hospital systems, each with its own PBM program and with the assistance of a blood center were able to grow their programs post-merger. As data mining is critical for effective PBM, the session will also discuss the challenges of integrating information using two different laboratory software systems and electronic medical records. Finally, the session will discuss the process of how two different hospitals reconcile commonalities and differences in efforts to harmonize performance and to leverage best practice synergies to improve PBM influence.