Quality indicators (QIs) are increasingly used to summarize quality of care and to give professionals' performance feedback. We have previously developed a continuous multifaceted guideline implementation strategy that integrates computerized decision support with feedback on QIs and benchmarking. This paper focuses on development of QIs, and presents results of a case study in the field of cardiac rehabilitation. We present a modified Rand method that combines results from a literature search and guideline review with knowledge of an expert and patient panel in an extensive rating and consensus procedure. All sources contributed to the final set of 18 QIs for cardiac rehabilitation.