Guideline implementation fails to improve thrombolytic administration

Background: International randomised controlled trials conducted over the last two decades have consistently demonstrated improved mortality and morbidity resulting from thrombolytic therapy for patients with acute myocardial infarction (AMI). Subsequently, evidence-based guidelines have been designed and implemented to optimize thrombolytic delivery. The effect of evidence-based clinical guidelines on clinical practice is heavily influenced by strategies used to develop, disseminate and implement those guidelines. Aims: This study evaluated the impact of a collaborative, multifaceted implementation strategy for AMI management guidelines on thrombolytic usage in the Loddon Mallee Region, Victoria, Australia. Intervention: The multi-faceted implementation strategy included an interdisciplinary team representing all treating venues contributing to the content of the ‘‘Guidelines for the Early Management of Acute Myocardial Infarction’’ followed by education sessions that coincided with the dissemination of the guidelines.