The BryanLGH Heart Improvement Program is a heart failure clinic at BryanLGH Heart Institute dedicated to the evaluation and management of patients with heart failure. The goal of the Heart Improvement Program is to provide a comprehensive diagnostic and treatment program for the heart failure patient that includes: the evaluation of the patient for correctable cause, optimization of conventional medical management, placement in an investigational drug trial if eligible, referral for transplant if eligible, patient education, rehabilitation and long-term follow-up.

The Physician Director of the program is Dr. Steve Krueger. Nurse Coordinator is Pat VerMaas, RN, APRN. Staff in the program includes two masters-prepared Nurse Practitioners, one with a doctorate, four bachelor-prepared registered nurses and three ancillary staff.

Collaboration with a cardiac rehabilitation program offers exercise classes specific for heart failure patients, as well as the phase-specific programs.

Patients are referred to the program by the cardiologists at BHI and/or their family physician. Patients initially undergo a cardiac evaluation, including an assessment of the etiology of their heart failure. A MUGA scan (multi-gated acquisition scan) and/or echocardiogram is usually done as part of their baseline evaluation to determine left ventricular function. If it is determined that medical management is the best option, they are referred to the Heart Improvement Program. Patients are seen in the clinic on a weekly, bi-weekly, monthly, quarterly, and/or as needed basis. Clinic visits consist of a cardiovascular exam, labs and EKG as warranted, medication review, uptitration of medications with appropriate monitoring (blood pressures, heart rate), and patient education, including disease process, medications, diet and fluid restrictions, and activity/exercise needs. Patients are routinely seen by the nursing staff, and by a cardiologist if after assessment it is determined that further medical evaluation and treatment are needed. Once patients have reached optimal medical therapy, a cardiopulmonary exercise test is performed to further evaluate their cardiac function and to develop an exercise program. Patients are seen annually by the cardiologist at which time a MUGA scan or echocardiogram, as well as labs and EKG, are performed.

Heart failure is a major consumer of health care dollars. Heart failure clinics across the nation have proven their effectiveness in reducing hospitalizations of heart failure patients, decreasing length of stay if hospitalization is needed, and improving quality of life. The Heart Improvement Program at BryanLGH Heart Institute is no exception. In seeing over 500 patients on a routine basis we have noted a significant impact on decreasing hospitalizations, reducing mortality and improving quality of life in these chronically ill patients.