PNP managed cardiology clinics demonstrate comprehensive utilization of nursing resources to effectively meet the needs of paediatric cardiology patients. This unique clinical care delivery model also addresses two of the six aims of quality improvement targeted in the landmark report by the Institute of Medicine (2001), Crossing the Quality Chasm:timely access to appointments and patient centred care. In other ambulatory clinics where gaps in patient access exist,this model serves as an option to meet their unique needs.Worldwide, this model has potential to provide care in areas where access to subspecialists is limited.