Purpose: To develop, implement, and sustain an ambulatory heart failure pathway. Methods: A multidisciplinary stakeholder committee including representation from family medicine, internal medicine, and cardiology met to review available guidelines and develop a pathway to inform ordering of labs/studies, medication management, and referrals for heart failure care. Pathway education was shared at various network events followed by tailored education to individual practices as part of an iterative rollout. This included a practice facilitator meeting with clinical and clerical staff to review the pathway and provide implementation support. Metrics to assess pathway implementation will include staff completion of pre-visit planning in addition to admissions and readmissions for HF. Conclusions: Creating an ambulatory heart failure pathway through iterative multidisciplinary consensus was feasible within a large health system. Implementation of the pathway requires stakeholder buy-in at the practice level, education sessions for clinicians and staff, and support from a practice facilitator. Further study is needed to identify optimal processes for sustained use and capacity to interface with other pathways.