Introduction: In 1995, the evidence-based Clinical Practice Guidelines for the Management of Early Breast Cancer were released in Australia and disseminated by the National Breast Cancer Centre. These guidelines are based on systematic reviews conducted by groups such as the Cochrane Collaboration's Collaborative Review Group in Breast Cancer. The National Breast Cancer Centre has developed and trialled a range of implementation strategies to facilitate guideline adoption. International evidence indicates that academic detailing kits are one such effective method of encouraging guideline implementation. The current project focusses on quality improvement through the development of a kit aimed at hospitals addressing barriers in health service delivery and structural change to facilitate guideline implementation. The Quality Improvement Kit concentrates on several recommendation topics drawn from the guidelines which have been identified in a national survey of treatment practices as areas of poor compliance. These topics include clinical trials, multidisciplinary care, information and counselling, diagnosis and follow-up. The kit provides detailed strategies to facilitate guideline adoption with particular emphasis on data management and clinical audit. Preliminary results from three pilot sites indicate that the kit is useful for directing and coordinating activities which promote structural change to enable guideline adoption. A randomised controlled trial of 20 hospital sites, supported by the National Health and Medical Research Council, is underway to evaluate the impact of the Quality Improvement Kit on changing policy and practice within the hospital setting. The findings of the pilot and trial studies will be presented.

Objectives:
Methods:
Results:
Discussion: