The prevalence of Heart Failure (HF) throughout British Columbia (BC) is reaching epidemic proportions. Irrespective of BC's significant health care infrastructure, resources and clinical expertise, patients with HF remain one of the leading causes for hospital admission as well as one of the largest cost items to the BC health care system. Currently in BC there are only pockets of organized HF care and there is inequity of access to HF resources such as advanced diagnostics and HF specialty expertise. Additionally, there is no standardized provincial integration of HF care across the care continuum. With financial support from Cardiac Services BC, a new provincial HF strategy has been established to address these issues. This included the creation of a new Provincial HF Clinical Nurse Specialist (CNS) and Physician role to lead the strategy. In this session the mandate and desired outcomes of the British Columbia HF strategy will be described. The central role played by the Provincial HF CNS in co-leading the strategy will be brought to life through “on the job” examples of each of the 5 CNS core functions identified by the Canadian Nurses Association. The challenges and successes experienced in inaugurating the role will be shared with an emphasis on utilizing the principles of strategic organizational change theory to overcome the challenges. Lastly, informed by evaluation data, the potential of this new HF CNS role to showcase CNS expertise and provide the foundation for expanded cardiac CNS practice opportunities will be highlighted.