The UCLA Cardiovascular Hospitalization Atherosclerosis Management Program (CHAMP) was developed and implemented starting in 1994. It was based on our hypothesis that a treatment algorithm that focused on initiating secondary protection measures prior to hospital discharge would be a more effective way of initiating treatment and would improve physician and patient compliance. The program focused on initiation of aspirin, cholesterol lowering medication (titrated to LDL < 100 mg/dl), beta blocker, and angiotensin converting enzyme (ACE) inhibitor therapy in conjunction with dietary and exercise counseling in patients with established coronary artery disease prior to hospital discharge. This was the very first program ever described to employ in-hospital initiation of cholesterol lowering therapy.

CHAMP was designed to integrate the use of secondary prevention measures into the standard cardiac care provided during hospitalization. The aim was to make initiation of atherosclerosis treatment simple, easy, and fast. By starting treatment in the hospital, we surmised that secondary prevention medical therapy would be more likely to be continued on an outpatient basis, resulting in improved long-term treatment rates and clinical outcomes. 

A team of cardiologists, primary care physicians, cardiac nurses, and pharmacists worked together to implement the program. CHAMP targeted all patients hospitalized with coronary artery disease including those with chest pain, unstable angina, acute myocardial infarction, cardiac catheterization, angioplasty, coronary bypass, and ischemic heart failure. The program has expanded in the past few years to also include patients hospitalized with cerebral vascular disease, peripheral vascular disease, and diabetes. The program algorithm calls for CHAMP medications being started on admission, continued during hospitalization (with dosing modified as indicated), and then included as discharge medications. Patient education on the benefits and potential side effects of the medications, diet, and other lifestyle modifications as well as a detailed follow-up plan are provided prior to discharge.  The premise for this program was that in-hospital initiation of treatment would result in better patient and physician compliance then treatment started on an outpatient basis weeks or months later.

A number of different tools were developed for CHAMP and were essential in making the program successful. Pre-printed admission orders, focused guidelines, pocket cards, educational programs, and discharge forms were used to facilitate treatment use. These also served as educational tools for housestaff, nurses, and attending physicians. Feedback was regularly provided to physicians and nurses in the form of updates and progress reports on patient treatment rates and program goals. Only existing resources and medical personnel were used to implement the program (a helpful point in getting initial approval from the medical center administration).