Coagulopathy in the bleeding surgical patient can get worse by the second! One of the real-world operational challenges in critical perioperative bleeding is balancing fast access to relevant clinical diagnostics, while maintaining compliance. Our session will provide an overview of the importance of functional whole blood viscoelastic tests (VET; e.g., Quantra, ROTEM, TEG) to assess hemostatic competence, and guide transfusion decisions. During the presentation, a comparison of the available methodologies will be made, along with actions taken to provide speed, quality and oversight during a recent patient-centered implementation at a large academic medical center.