TY - JOUR AB - Purpose Customer satisfaction refers to the extent to which customers are happy and satisfied with the products and services provided by a business. The purpose of this paper is twofold: first, to integrate lean tools in the analysis of customer satisfaction and, second, to examine its implications for research and practice.Design/methodology/approach The author proposes the combination of three lean tools in order to design a service quality system that has customer expectations (CEs) as the first input. These tools are quality function deployment (QFD), Hoshin Kanri planning process (HKPP) and benchmarking. The author uses a case study to show the functionality of these tools and the final design of a service quality system for a medical center.Findings Interaction between the service provider and the customer is the primary core activity for service-oriented businesses of different natures. A key relationship between trust in service quality and customer satisfaction cannot be ignored in interpersonal-based service encounters. However, there is a gap in the literature in terms of standardized lean-based procedures or methodologies that lead to improved customer satisfaction that are based directly on CEs.Research limitations/implications Given the variety of the population, the authors developed several methodologies to standardize the customer responses. Using several total quality management tools, the standardization allows the authors to separate the different CEs. The gathering of customers’ expectations (voice of the customers) allows the companies to focus on the real problems expressed by the users of the service, increasing their loyalty and, most importantly in the field under study, the customer’s satisfaction with the service received.Practical implications For practitioners, this study helps with the use of lean tools such as QFD, benchmarking and HKPP and attempts to bridge such a gap with an evidence-based real case.Social implications With the incorporation of all the customer needs, additional elements must be considered in the design of new services. Availability for all and sustainability play an important part of the CEs.Originality/value This paper presents a real application of QFD and Hoshin Kanri and how they may help the service organizations with future development. VL - 26 IS - 3 SN - 1463-5771 DO - 10.1108/BIJ-01-2017-0007 UR - https://doi.org/10.1108/BIJ-01-2017-0007 AU - Gonzalez Marvin E. PY - 2019 Y1 - 2019/01/01 TI - Improving customer satisfaction of a healthcare facility: reading the customers’ needs T2 - Benchmarking: An International Journal PB - Emerald Publishing Limited SP - 854 EP - 870 Y2 - 2024/04/26 ER -