It is a difficult task to define practical guidelines and a pragmatic achievement for the new document of the Italian Ministry of Health for structures of the national health system obtaining a quality system according to the ISO 9000 standard. The present article illustrates the different steps to accomplish the quality management in our cardiology department, recently internationally certified, and it gives several practical examples of the path followed in the different sections of the department to obtain the best management of all the Operative Units, identifying customer requests and measuring customer satisfaction.