The National Blood Authority formulates an evidence / expert opinion-based MHP template and recommends that hospitals have standardised MHPs to assist clinicians in management of critically bleeding patients. It is unknown if, or to what extent, these recommendations are implemented at an individual facility level. There also is no guidance or evidence around how facilities with limited resources (i.e. almost all regional / remote sites) adapt and implement the NBA guidelines to suit their facilities. We will present the findings from the first phase of our three-phase multi-modal study that is reviewing the composition, quality and delivery of MHPs across Queensland Health. We have reviewed every MHP across the state and found significant inconsistencies, even between sites with similar resources and capabilities, leading to potential inequities in care. We also identify gaps in the evidence with regard to real-world application of evidence-based guidelines.