BACKGROUND AND OBJECTIVES: There is concern about sustaining the O negative blood supply, especially in areas with many rural/remote hospitals like British Columbia. Red blood cells are perishable, making inventory management challenging. Demand must be met without wasting this precious resource. Inventory management challenges stem from data scarcity and human factors. Transfusion medicine technologists, who manage inventory daily, are key to understanding the human factors in inventory management. We conducted a qualitative study to understand technologists' inventory management perspectives and experiences, particularly for group O negative red blood cells, aiming to inform future inventory modelling to address human factors. MATERIALS AND METHODS: We interviewed transfusion laboratory technologists and technical leads from all health authorities and a blood product supplier representative for the Province of British Columbia. Thematic analysis of the interview transcripts was conducted. RESULTS: We found five themes that influence technologist decision-making on RBC inventory management, key challenges for O-negative RBCs, and identified inventory management strategies. We compare the top three inventory practices from our results with literature. CONCLUSIONS: Our findings help bridge the knowledge gap concerning human factors in RBC inventory management, with potential generalizability to other jurisdictions. They hold promise for informing the safeguarding of donors' altruistic contributions.