From its foundational years, transfusion medicine (TM) has been associated with errors and their reporting. Patient safety and quality were brought to the forefront of health care through the Institute of Medicine’s two reports followed by the WHO (2004) forming a world alliance of 140 nations. Error reporting in TM has gradually evolved into continuous quality improvement (CQI) and risk management. The review provides insights into the use of quality indicators (QIs), quality tools, and CQI and the models for improvement in TM. QIs in TM have been identified in the past decade; a comprehensive list is provided by the International Society of Blood Transfusion (2019). Analysis of QIs by different tools aids decision-making. Root cause analysis is best carried out using the 5 Whys along with fishbone analysis. Failure-mode-effect-analysis is useful for risk assessment. A process map helps in identifying bottlenecks in a process. A Pareto diagram identifies the “vital few” problems. Likewise, histogram, run diagrams, scatter diagram, and driver diagram, have their own use. Underperforming indicators need to be taken up for quality improvement projects (QIPs). QIPs are designed and implemented by using any of the models available, depending on the problem on hand: the Model for Improvement, FOCUS-PDCA, Six Sigma, and Lean Six Sigma. The utility of clinical audits in improving the quality of transfusion practices and processes cannot be overemphasized. With a structured approach, “goodness” in TM can be measured, and made better. CQI ensures that the journey does not end at “good to great” but continues to progress from “great to greater.”