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This study aims to investigate and test the impact of competitive priorities, in terms of quality, speed, dependability, flexibility, cost and patient engagement, on patient satisfaction with healthcare services. It considers patients’ rather than managers’ points of view to collect responses about competitive priorities.

This research employed a cross-sectional survey design to analyze a sample of customers through an empirical study of 488 patients in Qatar’s healthcare service context.

The confirmatory factor analysis results show that competitive priorities and engagement positively and significantly impact patient satisfaction.

Researchers can use this methodology to explore the role of competitive priorities in different service contexts and sectors. The researchers conducted the study in Qatar; therefore, the results are not generalizable to all healthcare sectors. However, regardless of geographic location, the research approach can be used in healthcare.

Managers can employ the developed scales to diagnose competitive priorities and improve customer service experiences.

The paper is original as it suggests using competitive priorities as a measurement tool for predicting patient satisfaction compared to prior research that mostly measured competitive priorities based on internal perspectives (managers’ perspectives). Further, this paper is original because it depends on the external perspective (customers’ perspective) for the competitive priorities for measuring patient satisfaction.

The purpose of this research is to provide an introduction into Hoshin Kanri and how it has been used with other methodologies and frameworks. Additionally, factors that impact successful Hoshin Kanri implementation and future research opportunities are explored.

A systematic literature review was conducted to determine the methodologies and frameworks that have previously been explored and identify factors that lead to successful Hoshin Kanri implementation as it relates in the Western world.

Even though Hoshin Kanri has been used to a limited extent for decades in the West, there is still relatively little published research on the topic. In the period reviewed most published research was performed in the UK or USA. In addition, most years had less than two publications (the exception being five in 2020).

This literature review was primarily focused on the manufacturing sector, publications from 1990–2021, and available in English.

Current practitioners may use the research in this review to improve their current Hoshin Kanri practices using the techniques mentioned as a means of continuous improvement or to build a new framework for their own needs.

This paper makes an important contribution to the study of Hoshin Kanri as it provides: (1) an updated literature review regarding the study and application of Hoshin Kanri, (2) a qualitative analysis of alternative methodologies and frameworks to traditional Hoshin Kanri and (3) success factors when considering implementation of Hoshin Kanri within an organization and researchers with potential ideas for future research.