When treating heart attack patients, simply following evidence-based practices or protocols, like administering a beta blocker, may not be enough. A study in the March 15 issue of Annals of Internal Medicine, supported by The Commonwealth Fund, examined 11 hospitals in either the top or bottom 5 percent of performers on 30-day risk-standardized mortality for acute myocardial infarction and found no substantial differences in the use of such protocols.