Despite advances in the prevention and treatment of many cardiovascular diseases, congestive heart failure (CHF) remains a major cause of morbidity and death in most developed countries. During this era of uncertainty in health care, cost-conscious tactics are being implemented widely among U.S. hospitals. One such tactic, in the form of a multidisciplinary outpatient CHF clinic, was implemented in June of 1995 at a university medical center in the southeastern United States. This article discusses the process of developing a collaborative multidisciplinary outpatient CHF clinic, and the concomitant clinical development of the nurse practitioner role.